Number of neonatal intensive care units falls short in Korea
By Kim Tae-jong
Preterm infants are more frequently being born, but neonatal intensive care units fall short of fulfilling the increasing need.
According to Statistics Korea, the birthrate of preterm infants weighing under 2.5 kilograms account for 4.9 percent of the total births in 2009, rising from 4.3 percent in 2005 and 3.8 percent in 2000, showing a greater need for care units.
Rural areas suffer more as experts said medical facilities and staff there still fail to effectively support preterm infants.
“The government has been trying to increase the birthrate, but it is also important to take care of newborn babies and help them grow healthily, which the government neglects now,” said Chang Yun-sil, a professor at the Department of Pediatrics at the Samsung Medical Center.
A high preterm birthrate is usually seen in developed countries with low birthrates where women give birth at comparatively older ages, she said.
“The nation’s preterm birthrate will increase to 7 to 10 percent in the future, and we have to prepare for it,” she predicted.
But the number of neonatal intensive care units dropped to 93 in 2010 from 143 in 2005, consequently decreasing the number of beds nationwide to 1,252 from 1,731.
Such a decrease is a major problem, especially outside of city centers. North Chungcheong Province, for instance, has reported only one neonatal intensive care unit with four pediatrics doctors and one night-duty doctor available.
The decrease of medical facilities for preterm infants is attributed to the fact that many hospitals suffer from a shortage of human resources and prolonged deficits.
“For hospitals, it’s not profitable to operate a neonatal intensive care unit. It’s not fair to expect hospitals and medical staff to take care of preterm babies, totally relying on their devotion and sacrifice,” she said.
There should be at least 200 to 600 more beds nationwide to meet the increasing need, she said, asking for more government support.
Survival rate of preterm infants
The survival rate of low birth weight infants in the country has significantly improved over the past 50 years, according to a recent research.
According to a journal by five pediatrics professors, the survival rate of very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI), whose birth weight is less than 1,500 and 1,000 grams have been on the increase.
The survival rate of VLBWI increased to 85.7 percent in 2009 from 31.8 percent in the early 1960s and 65.8 percent in the early 1990s. The survival rate of ELBWI increased to 71.8 percent in 2009 from 8.2 percent in the early 1960s and 37.4 percent in the early 1990s.
Titled “Recent Trends in Neonatal Mortality in Very Low Birth Weight Korean Infants,” the journal was written by professors Hahn Won-he, Chang Ji-young, Shim Kye-shik and Bae Chong-woo of the Department of Pediatrics at Kyung Hee University in collaboration with Chang from the Samsung Medical Center.
In comparison, the survival rate of VLBWI stood at 92 percent in 2008 in Japan and 92.6 percent in 2006 in the U.S. and the survival rate of ELBWI was 85.5 percent in 2008 in Japan and 85.0 percent in 2006 in the U.S.
The better statistics are largely attributed to more advanced medical care systems in both countries, the journal analyzed, adding the survival rates for VLBWI and ELBWI in Japan are the highest in the world and could be achieved with its foremost perinatal care system.
To attain similar improvements in Korea, an organization of perinatal care centers, nationwide neonatal and perinatal research networks, and regionalization of neonatal and perinatal medicine is needed, Bae said.
“We still lack neonatal intensive care units, related devices and the government’s support. Without these things, it’s hard to make progress in the survival rates of preterm infants, especially in rural areas where only limited facilities and medical staff are available,” he said.