Specialized perinatal care: impact on perinatal mortality

Area of Science:

• Perinatal Medicine
• Neonatal Care
• Obstetrics

Background:

• Neonatal and perinatal mortality rates were high in 1972 (7.6 and 20.9 per 1000 deliveries, respectively).
• Limited access to specialized neonatal and high-risk obstetric care contributed to these rates.

Purpose of the Study:

• To evaluate the impact of establishing a neonatal intensive care unit (NICU) and a high-risk pregnancy unit on neonatal and perinatal mortality.
• To assess the effect of these interventions on cesarean section rates and indications.

Main Methods:

• Centralization of obstetric and neonatal care at a single hospital.
• Introduction of a neonatal intensive care unit (NICU) starting in 1972.
• Partial and full implementation of a high-risk pregnancy unit for fetal monitoring from 1973 onwards.

Main Results:

• Neonatal mortality decreased from 7.6 in 1972 to 3.4 in 1974 and 3.8 in 1975.
• Perinatal mortality decreased from 20.9 in 1972 to 9.0 in 1974 and 8.9 in 1975.
• Cesarean section rates increased slightly from 10.1% (1972-73) to 11.6% (1974-75), with more specific indications.

Conclusions:

• Centralization of care and specialized teams significantly reduced perinatal and neonatal mortality.
• Fetal monitoring did not increase cesarean section rates but led to more specific indications for the procedure.