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BMC Pediatrics
Published in: BMC Pediatrics 1/2017

Open Access 01-12-2017 | Research article

Improved referral and survival of newborns after scaling up of intensive care in Suriname

Authors: Rens Zonneveld, Natanael Holband, Anna Bertolini, Francesca Bardi, Neirude P. A. Lissone, Peter H. Dijk, Frans B. Plötz, Amadu Juliana

Published in: BMC Pediatrics | Issue 1/2017

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Abstract

Background

Scaling up neonatal care facilities in developing countries can improve survival of newborns. Recently, the only tertiary neonatal care facility in Suriname transitioned to a modern environment in which interventions to improve intensive care were performed. This study evaluates impact of this transition on referral pattern and outcomes of newborns.

Methods

A retrospective chart study amongst newborns admitted to the facility was performed and outcomes of newborns between two 9-month periods before and after the transition in March 2015 were compared.

Results

After the transition more intensive care was delivered (RR 1.23; 95% CI 1.07–1.42) and more outborn newborns were treated (RR 2.02; 95% CI 1.39–2.95) with similar birth weight in both periods (P=0.16). Mortality of inborn and outborn newborns was reduced (RR 0.62; 95% CI 0.41–0.94), along with mortality of sepsis (RR 0.37; 95% CI 0.17–0.81) and asphyxia (RR 0.21; 95% CI 0.51–0.87). Mortality of newborns with a birth weight <1000 grams (34.8%; RR 0.90; 95% CI 0.43–1.90) and incidence of sepsis (38.8%, 95% CI 33.3–44.6) and necrotizing enterocolitis (NEC) (12.5%, 95% CI 6.2–23.6) remained high after the transition.

Conclusions

After scaling up intensive care at our neonatal care facility more outborn newborns were admitted and survival improved for both in- and outborn newborns. Challenges ahead are sustainability, further improvement of tertiary function, and prevention of NEC and sepsis.
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Metadata
Title
Improved referral and survival of newborns after scaling up of intensive care in Suriname
Authors
Rens Zonneveld
Natanael Holband
Anna Bertolini
Francesca Bardi
Neirude P. A. Lissone
Peter H. Dijk
Frans B. Plötz
Amadu Juliana
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2017
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-017-0941-6

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