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Published on: August 25, 2014
[Perinatal care in the Marche region 1983. Results of an epidemiologic study]
Insights
Perinatal care in Marche showed too many services and poor risk pregnancy centralization, leading to increased newborn transfers and mortality. Regionalization of services is recommended for better outcomes.
Area of Science:
- Obstetrics and Gynecology
- Neonatalogy
- Public Health
- Epidemiology
Context:
- Analysis of perinatal care in the Region Marche, Italy, during 1983.
- Comparison with Swedish data from 1979 and Friuli Venezia Giulia data from 1980 for very low birth weight infants.
- Evaluation of obstetric and neonatal services categorized by levels of care (III, II, I, and sublevel).
Purpose:
- To provide a comprehensive overview of perinatal care in the Region Marche.
- To analyze natality, perinatal, and neonatal mortality rates in relation to birth weight.
- To assess the impact of newborn transfers on neonatal outcomes.
Summary:
- The study identified an excessive number of obstetric services and a lack of centralized care for high-risk pregnancies in the Region Marche.
- Frequent transfers of sick newborns were observed, with a correlation between transferred infants and higher neonatal mortality in specialized care units.
- Epidemiological data revealed suboptimal perinatal care indicators compared to other regions/countries.
Impact:
- Highlights the need for regionalization of obstetric and neonatal services.
- Recommends early identification and in-utero referral of high-risk pregnancies.
- Advocates for a planned, regional transport system for sick infants to improve survival rates.
Abstract:
The purpose of this study was to offer a significant picture of perinatal care in the Region Marche. Natality, perinatal and neonatal mortality of 1983 were analysed with reference to birth weight. The obstetric and neonatal services were subdivided, according to the levels of reproductive medical care, in level III, level II, level I and sublevel. The transfers of newborn to the hospital with a service of neonatal pathology or with a neonatal intensive cure unit were taken into account. Our epidemiological data were compared with epidemiological data of Sweden in 1979 and, for very low birth weight infants, with epidemiological data of the Region Friuli Venezia Giulia in 1980. The results have shown the excessive number of obstetric services in the Region Marche, the lack of centralization of risk pregnancies, the frequent transfers of sick newborns, the positive relationship between transferred infants and a greater neonatal mortality in the services of special and intensive neonatal care. The study indicates that it is suitable a program of regionalization of obstetric and neonatal services for an early individualization and in utero referrals of risk pregnancies, for a planned on regional basis transport of sick infants.
