Comparing neonatal care in four developing countries.

“When compared with the United Kingdom, Australia, and Canada, the United States has the largest workforce dedicated to neonatal care, it has 4.9 times the number of neonatal intensive care beds as the United Kingdom, and the combined number of intensive care and intermediate care beds is twice as large as it is in Australia and Canada. Yet a recent study shows that U.S. infants don't have proportionately better survival rates: the infant morality (the number of deaths in the first year of life per 1,000 live births) and the neonatal mortality rate (the number of deaths in the first 28 days per 1,000 births) are higher in the United States than they are in the other three countries. These findings refute the effectiveness of the current U.S. funding emphasis on neonatal care and make a case for more funding for preconception and prenatal care.”

“One explanation offered by the study's authors is that the other three nations place more emphasis on preconception and prenatal care than the United States does. While Australia, the United Kingdom, and Canada all proved universal health coverage, 38.8 million Americans (14.1%) are uninsured, with women and children disproportionately affected.”

“Another report supports these recommendations. It's a summary of a 1997 conference held by the Harvard Center for Children's Health and supported by a grant from Agency for Health Care Policy and Research, at which participants were charged with identifying measures to prevent premature births, intrauterine growth restriction, and congenital malformations. Although the presenters did so, they also acknowledged that these interventions have be of limited value because the factors posing the greatest risk to the fetus often occur too early in pregnancy for the interventions to be effective. The conference participants concluded that for prenatal care to be successful, more attention should be paid to improving women's health care and promoting healthful habits.”

Source: Thompson LA, et al. Pediatrics 2002; 109(6):1036-43; McCormick MC, Siegel JE. Ambul Pediatr 2001;1(6);321-5