Is the reception of babies requiring critical care one of the factors explaining the increase in early neonatal mortality? According to a study by researchers from Inserm, the University of Paris, AP-HP and Nantes University Hospital, published in March 2022, since 2012, France has seen a significant increase in the infant mortality rate.
“This 7% increase increased infant mortality from 3.32 in 2012 to 3.56 deaths per 1,000 live births in 2019,” Inserm said in a press release. A trend driven by an increase in early neonatal mortality (children born alive and dying within the first 7 days of life).
A “deterioration of the care circuit”
Given this alarming observation, the French Society of Neonatology (SFN), a scientific society that brings together professionals working around newborns, carried out an audit between 2021 and 2023 to evaluate the provision of neonatological care, particularly critical care. in the country. She revealed the main findings in a press release on Monday.
Among the hypotheses that may explain the increase in neonatal mortality, the SFN cites “the increase in the age of mothers at the time of childbirth, the increase in multiple pregnancies, precarious situations or even a deterioration in the care circuit.” “. The results of the SFN investigation into the provision of critical care in neonatology are “very worrying”, she warns.
Lack of space and lack of staff
First, it observed that the number of neonatal intensive care beds per 1,000 births ranged from single to double, depending on the region of the metropolis. In general, “the supply of neonatal critical care remains insufficient,” warns the SFN, with very high average occupancy rates.
In addition to this lack of space, these services often lack sufficient staff. “At least one pediatric neonatologist position is vacant in 73% of type 3 services, and two or more are vacant in 46% of services,” according to the SFN.
75 hour weeks for some.
As a result, among the 721 pediatric neonatologists (out of an estimated total of approximately 1,500) who responded to the scientific society’s survey about their quality of life at work, 80% reported working more than 50 hours per week, and 13 % more than 75 hours per week.
Working conditions that affect their personal life: 49% of the neonatologists surveyed stated that they had had sleep problems related to their work, and 17% said that they had experienced some episode of burnout or depression. “The main reasons for job dissatisfaction are excessive working hours and insufficient remuneration for guards,” explains the SFN.
Lack of seniority and training of nurses.
This also highlights the lack of seniority of the nursing teams, to which is added “the lack of initial training in pediatrics and neonatology, which were completely eliminated from the teaching of the state nursing diploma in 2009.
“There is enormous pressure on the teams,” he lamented. World Elsa Kermorvant, vice president of the SFN and neonatologist at the Necker hospital in Paris. “We are constantly playing musical chairs to distribute newborns who need it, we take a baby out of intensive care faster than we would like, we transfer it to other hospitals… But that is not possible to postpone births when come to term,” he said. aggregate.
For this reason, the French Society of Neonatology calls for a review of the organization of intensive care in neonatology.
Source: BFM TV
