New research shows that the survival of a baby born with a birth defect, otherwise known as a congenital anomaly, depends on where you were born.
The survival of a baby born with a birth defect depends on where you were born. Image credit: University of Birmingham
Children with intestinal insufficiency are more likely to die than one in five high-income countries, one in five in a middle-income country, and one in five in a low-income country.
Scientists from 74 countries (the journal Notes to Editor) studied the risk of death in almost 4,000 babies born with birth defects in 264 hospitals around the world.
Gastrosis, a birth defect when a baby is born through the umbilicus, has the largest difference in mortality, with 90% of children dying in low-income countries compared with 1% in high-income countries. In high-income countries, most of these babies will be able to live a full life without disability.
Just Astin Davis, a professor of UK research at the University of Birmingham, said: “In high, middle or low income countries, the differences between the lives and deaths of children born in these highly treatable conditions are tragic. It reflects a general lack of investment in investment in low- and middle-income countries. Most people in high-income countries are convinced that they can receive high-quality care if they or their children have a surgical condition, but this is not the case for many people around the world.»
Lead investigator Dr. Naomi Wright has spent the last four years researching these discrepancies in the results.
Geography should not determine outcomes for newborns who have corrective surgical conditions. The goal of sustainable development “to end the preventive deaths of infants by the age of 5 by 2030” is impossible without urgent action to improve surgical care for infants in low- and middle-income countries.
Dr. Naomi Wright, Chief Investigator
Researchers urge to focus on improving surgical care for newborns in low- and middle-income countries around the world.
Over the past 25 years, while there has been great success in reducing mortality in children under 5 years of age by preventing and treating infectious diseases, little attention has been paid to improving surgical care of infants and the proportion of surgical-related deaths. continues to rise.
Birth defects are now the fifth leading cause of death in children under 5 years of age in the world. Most deaths occur in the newborn. 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 highlights the importance of perioperative care at the pediatric surgery center (both sides of the correctional operation or procedure received care). Children treated in hospitals were more likely to die if they did not need ventilation or 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.
Improving survival from these conditions in low- and middle-income countries includes three key elements:
- Improving prenatal diagnosis և childbirth in a hospital with surgical care of children;
- Improving the surgical care of children born in regional hospitals – safe and fast transfer of children to the surgical center. և:
- Improved perioperative care for children in the pediatric surgery center.
This requires strong teamwork և planning for obstetrics և obstetrics teams, newborn և pediatric groups և pediatric surgery teams երեխաների pediatric surgery center, and education և referral hospitals.
In parallel with local initiatives, surgical care of infants և children should be integrated into national և international child health policies և otherwise շրջանակներում should not be neglected in the context of global child health.
PaedSurg Global Research Collaboration (2021) Mortality from congenital anomalies of the gastrointestinal tract in 744 hospitals in 264 low-income, middle-income, and high-income countries. Multicenter, international, perspective group study. The Lancet, doi.org/10.1016/S0140-6736(21)00767-4.
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