Mortality rate of very premature babies twice that in other Western countries

Needless infections and deaths result from lack of manpower, funds, according to Israeli Premature Baby Forum report.

By JUDY SIEGEL-ITZKOVICH
A PREMATURE BABY born in an Israeli hospital 370 (photo credit: Courtesy Forum for Premature Babies)
A PREMATURE BABY born in an Israeli hospital 370
(photo credit: Courtesy Forum for Premature Babies)
Eighty percent of premature babies do not receive the treatment they need after delivery or after their discharge from hospital neonatal intensive care units, according to a report by the Israeli Premature Baby Forum released in honor of International Preemie Day on Tuesday.
The forum is chaired by MK Orly Levy-Abecassis, chairwoman of the Knesset’s Children’s Rights Committee.
The main problem is the lack of medical manpower to take care of them and advanced facilities to accommodate them.
There is an urgent need for 151 more neonatologists, 670 nurses and 110 more neonatal intensive care beds, the report said.
The birthrate of babies of verylow birthweight (VLBW) – under 1,500 grams – has remained steady in recent years at about 1% of deliveries.
The mortality rate of VLBW babies is steady at 15.3% or 269 infants last year. But the mortality rate of preemies weighing less than one kilo is twice than in other Western countries, indicating a serious problem.
Deaths from pneumonia remain the same while the number of such patients has slightly increased, the report said.
Another major cause of death is blood infections.
The report noted that insurance companies “unanimously refuse” to offer private medical insurance for premature babies, even though many parents want to purchase it.
“We have to continue our public struggle for premature babies. We must join forces to reduce the morbidity [prevalence of illness] and mortality of preemies. Resources must reach them... We will formulate clear decisions and conclusions to ensure their survival,” Levy-Abecassis said on Monday The number of preemies born each year is increasing. In 2012 there were 15,385, 373 more than were born in 2011 in which there were 49 more premature babies born than in the previous year.
Nearly 5,000 premature babies were not entitled, because of their age, to state-supplied vaccinations against respiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages and is a major cause of respiratory illness in young children.
The forum said that the National Insurance Institute should increase its financing of hospital treatment of preemies weighing less than 1,750 grams by another NIS 50,000 each.
Babies born after the 34th week of pregnancy (40 is term birth) are treated in regular neonatal departments and not in neonatal intensive care units. Thus they do not receive nutritional enrichment and professional counseling suitable to preemies, the report said.
About nine out of 10 preemies are not eligible for developmental follow-up and professional support in the community after they are discharged.
Dr. Shmuel Tzangen, chairman of the Israel Neonatology Society and a member of the forum said the situation is “far from optimistic.”
“The number of premature births continues to rise, and the death rate among VLBW babies is still high compared to Western countries like the US, Canada and Japan.”
Due to the shortage of doctors, nurses and suitable beds, he said, “we will not be able to give them the optimal treatment for their special needs.”
Asked to comment, the Health Ministry spokeswoman said that premature babies “are on our agenda.”
It has decided to add 240 neonatal intensive care beds through 2016, job slots for 80 more neonatologists and 336 for nurses during that period. The Treasury, she said, has agreed to add NIS 80 million for this over four years.
As hospitals earn more from regular births subsidized by the NII, they don’t invest as much in neonatal intensive care units, she said. Thus the ministry will in 2014 institute an incentive program to encourage hospitals to ensure there are more filled manpower slots and more advanced equipment for premature baby units and to do better to prevent infections.
During the past two years, the spokeswoman continued, special teams to prevent infections in premature baby units visited hospitals and sent the findings to hospital directors on shortcomings.
The teams demanded that the problems be fixed.
Finally, changes will be made in the training of neonatologists, including the possibility that doctors may study the specialty directly rather than first becoming an advanced pediatrician.