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Extra info for Avery’s Neonatology: Pathophysiology and Management of the Newborn
A survey of 394 NNPs in the United States found that the distribution of primary practice site was a community hospital for 54%, an academic medical center for 37%, a private practice for 5%, and a managed care organization for 4% (40). These practitioners were most likely to practice with physicians with a collaborative agreement (41%), supervised by a physician (33%) or in a multidisciplinary practice including physicians (24%); independent NNP practice was rare (2%). Similar to neonatologists, distribution of NNPs varies regionally and is often not matched to demand.
Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epidemiol 2006;35:706. 1093/ije/dyl043. It is therefore not surprising that different countries have adopted different standards for limits of viability and resuscitation. While many high-income countries routinely provide active resuscitation for infants at 24 to 25 weeks of gestation and sometimes even as low as 21 weeks of gestation, this is not necessarily the case in low-income countries. 13 ▪ ESTABLISHING INFRASTRUCTURE TO REDUCE MATERNAL AND INFANT MORTALITY IN THE DEVELOPING WORLD The Every Newborn Action Plan (59), Lancet Series on Neonatal Survival (60) and Preterm Birth (61,62,63), and the Born Too Soon: The Global Action Report on Preterm Birth (15) propose actions for policy, programs, and research by all partners, from governments to NGOs to the business community.
Over 1 million of these infants died in 2013, making preterm birth complications the leading cause of death among children under 5 years of age. Across 184 countries, the rate of preterm birth ranged from 5% to 18% of all live births (16). Resource-poor regions of the world have excessive burdens of preterm birth, LBW, small size for gestational age, stillbirth, infant mortality, and maternal mortality. More than 60% of preterm births occur in Africa and Southeast Asia (16). 2. 6 (6). The percent of preterm births in the United States was about 40% higher than in countries in the United Kingdom and nearly 75% higher than in some Scandinavian countries (6).
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