030974 hs British evaluate, care of newborn

By HARRY NELSON

Los Angeles Times

BEVERLY HILLS, CALIF. -A British study has disputed the popular notion that giving intensive care to tiny babies results in a large number of seriously defective survivors who otherwise would mercifully have died.

The study shows that the opposite is true; a larger percentage of babies survive after receiving intensive care but far fewer of the survivors have serious mental or physical defects.

IT HAS BEEN reported that as many as 83 per cent of babies born weighing only two or three pounds are abnormal if they survive.

But Dr. D.V.1. Fairweather. director of obstetrics and gynecology at University College Hospital, London, has shown that intensive neonatal care reduces to about 10 per cent the number with mental or physical defects that can be detected.

Dr. Fairweather gave his report to an obstetrics and gynecological meeting here recently.

The British physician's study is the first evaluation of high risk babies who have received intensive supportive care immediately before, during and after birth.

ONLY A relatively few hospitals in the world have the doctors, and nurses capable of taking care or the special problems of tiny newborns. In England doctors are attempting to channel into those hospitals all high risk babies rather than having them delivered in community hospitals that do not have neonatal services.

Fairweather followed for five years 95 intensive care babies born weighing three pounds or less to determine how many developed defects, even subtle ones which may not have been noticeable at birth.

He found four had a physical handicap, five a mental and a physical handicap, a total of nine out of 95 or roughly 10 per cent.

THE HANDICAP rate is high among infants born at standard care hospitals because "not enough attention is being turned on them," the Britisher said.

He said skeptics have criticized intensive neonatal care on grounds it produces large numbers of defective babies at great cost who otherwise may have died.

-But our study suggests that measures to keep them alive would result in a greater number of normal survivors," Fairweather said.

lie said the chief reason they are normal is that elaborate precautions are taken to prevent the brain from being damaged by lack of oxygen. He said very small babies commonly stop breathing for a few minutes -- unless stimulated to keep breathing - and consequently may suffer brain damage.