Policy Issues on Neonatal Intensive Care for Low Birth Weight Infants

Abstract

This study is aimed at providing effective methods of Neonatal Intensive Care (NICU) Services for minimizing neonatal deaths and disabilities among low birth weight (LBW) infants. For this purpose, we conducted a survey of 97 national hospitals with NICU. We also examined the medical systems and rules related to NICU in the US, Japan, and the UK. In addition, we analyzed the LBW incidence and death rates among LBW infants based on national infant mortality survey data. The findings of this study include that the LBW (birth weight under 2500g) rates have been increasing every year, particularly, the incidence of VLBW (birth weight under 1500g) has risen to a great extent. The neonatal death rates among LBW infants, while high, varied across regions. Although LBW incidence rate is lower in Korea than in Japan, Korea's neonatal infant death rate is higher than Japan's, largely because the survival rate among LBW infants in the NICUs is lower in Korea. In the developed countries, care and management system for high risk infants have been established and managed for many years. The US has established and managed a perinatal care system at the regional level for high risk maternal and infants. In Japan, a prenatal care system was established in 1979, and it has been managed at the regional level since 1996. The UK has conducted in 2001 an inspection program on NICUs, in 2003 has embarked on standardizing equipments and facilities according to different risk levels. As NICU resources such as manpower, equipments, and facilities, are concentrated in large cities, the risk of death may be higher for newborns and infants in smaller cities and non-urban areas. We will propose that the properly supplements and distribution methods of facilities and beds needed for NICU. In addition, an intensive care system should be established for low birth weight infants and managed at the local level. Also, the need is urgent to produce accurate statistics on the causes and incidence LBW infant deaths.