Provision of perinatal services and survival of extremely low birthweight infants in Victoria.
The transfer of at-risk mothers to one of the three Level III maternity hospitals in Victoria has been promoted since 1975; since 1978, the Newborn Emergency Transport Service has been available throughout the State for the transport of infants to the four Level III neonatal units. By means of data from multiple sources, we ascertained the one-year survival of infants with birthweights of between 500 g and 999 g born in Victoria between 1978 and 1981. Of 711 live-born infants, 227 (31.9%) survived 28 days and 210 (29.5%) lived to at least one year of age; of 490 infants born in the Level III maternity units, 156 (31.8%) lived. There were 54 (24.4%) survivors among the 221 infants born elsewhere; all these survivors were included in the group of 105 babies who had been transferred after birth to Level III neonatal units. Although only 25.5% of all births for the State occurred in the Level III maternity hospitals, 69% of all infants who weighed between 500 g and 999 g at birth were delivered in these hospitals. The transfer of the mother or the new born baby to a Level III unit was possible in an additional 48 cases. Although survival rates from Level III hospitals may possibly improve in the future, the shortage of ventilator beds remains a practical obstacle.
D001315:Australia; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D011295:Prenatal Care / Q000592:standards*