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Geography determines the survival of newborns with birth defects

A global study of 74 countries found that the survival rate of children born with birth defects is highly dependent on the birth of a child, which calls on Australia to play a role in improving surgical care for children in other countries.

Published: The LancetThe study looked at the risk of death for nearly 4,000 babies born with birth defects in 264 hospitals around the world. Children with intestinal insufficiency were two to five times more likely to die in a low-income country than one in 20 in a middle-income country and one in 20 in a high-income country.

The 2019 Monon Monash Scientist Dr. Brenda Ones, along with Associate Professor Sebastian King Դ Dr. Damir Luhar, co-chaired Australia և New aland անդland, which is said to be the largest international study of children born with major congenital diseases.

“Associate Professor Sebastian King, Dr. Damir Luhar և I coordinated the study in Australia և New Zealand ենք We are saddened, but unfortunately not surprised, by the incredible disagreements between high-income countries such as Australia և New Zealand և low-income countries,” he said. :

“In Australia և New Zealand, we regularly care for children with diseases such as gastroscopy, with the full expectation that the child will not only survive, but will continue to thrive and live a full life. Australia և New Zealand should be proud that we can offer this expectation to our children and their parents.

“Following our involvement in this study, we encourage Australia և New Zealand to play a leading role in improving surgical care for children abroad.”

Gastroschisis – a birth defect where the baby’s intestines protrude through the umbilical cord, had the biggest difference in mortality. 90% of children die in low-income countries, compared to 1% in high-income countries. In high-income countries, most of these babies will be able to live a full life without disability.

Lead investigator Dr. Naomi Wright has spent the last four years researching these discrepancies in the results. He said. “Geography should not determine outcomes for newborns who have corrective surgical conditions. “The goal of sustainable development is impossible to end preventive deaths of infants and children under the age of five by 2030 without urgent action to improve surgical care for infants in low- and middle-income countries.”

Researchers stress the need to focus on improving surgical care for newborns in low- and middle-income countries around the world. For the past 25 years, while there has been great success in reducing under-five mortality by preventing ՝ treating infectious diseases, there has been little focus on improving surgical care for infants և, համ indeed, the proportion of surgical-related deaths. Diseases continue to grow.

Birth defects are now the fifth leading cause of death in children under the age of five in the world. Most deaths occur in infants. Intestinal defects have a particularly high mortality rate in low- and middle-income countries, as many are incompatible with a life without emergency surgery after birth.

In high-income countries, most women get a prenatal ultrasound to check for birth defects. In case of identification, it allows the woman to deliver the baby in the hospital with surgical care, so that the baby can receive help as soon as it is born. In low- and middle-income countries, children with these conditions will often be late to a pediatric surgery center in poor clinical condition. Research shows that infants who come to a pediatric surgery center with a septic infection are more likely to die.

The study also highlights the importance of perioperative care at the pediatric surgery center – care received through corrective action or procedure. Children treated in hospitals were more likely to die if needed without proper ventilation and intravenous feeding. Moreover, lack of skilled anesthetic support and failure to use a surgical safety checklist at the time of operation were associated with a higher risk of death.

Researchers have found that improving survival in these conditions in low- and middle-income countries involves three key elements:

  1. Improving prenatal diagnosis and childbirth in a hospital with surgical care of a child.
  2. Improving surgical care of newborns born in regional hospitals – pediatric surgical center with safe and fast transfer of children.
  3. Improved perioperative care for children at the Pediatric Surgical Center.

The team acknowledges that this requires strong teamwork ավորում planning midwifery և midwifery teams, newborn և pediatric groups և pediatric surgical teams և pediatric surgical teams հեռ parallel to distance learning ցանց a network of accompanying hospitals.

Researchers urge that in addition to local initiatives, surgical care of infants և should be integrated into national երեխաների international child health policies և otherwise neglected in global child health.

Image credit: © / au / mocker_bat


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