Perspective on Central & South America

A Global View on Birth Asphyxia: Perspective on Central and South America

Wally Carlo, from the University of Alabama Hospital, presented on birth asphyxia in Central and South America.

Dr. Carlo reviewed health care disparities in the Americas and spoke of the considerable discrepancy in health services (numbers of physicians, nurses and health care expenditures) available in poorer countries (Figures 7.1, 7.2, 7.3, 7.4, 7.5, 7.6). See below for full size figures.

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Maternal and infant mortality was inversely related to the availability of health services, especially prenatal care. As a result, infant mortality varied from a low of 5.2 – 9.9/1000 live births in U.S.A.and Canada to 30 – 80/1000 in several South and Central American countries (Figure 7.7). Similarly, maternal mortality varied from a low of 2.9 – 19/100,000 births in some of the more affluent countries to a high of 114 – 523/100,000 in poorer countries, with limited health services (Figure 7.8).

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These disparities were paralleled by the number of health workers providing prenatal care or attendance at birth.

Dr. Carlo examined reports of the percentage of neonatal deaths due to asphyxia. Again, there was a tremendous disparity, varying from 32% in Argentina and Uruguay to 3% in Costa Ricaand 10% in Brazil. The reason for this disparity was not apparent and may relate to the definition of birth asphyxia used in each country and/or the accuracy of reporting.

Dr. Carlo referred to the work of Revelo-Castro et al concerning the impact of a country-wide application of a neonatal resuscitation program. Dr. Revelo-Castro presented his work in the platform presentation portion of the symposium. He showed that this program in El Salvadorhad a significant effect in reducing neonatal mortality. Dr. Revelo-Castro’s presentation is shown in its entirety here.

Abstract: Oswaldo Revelo-Castro, Carlos Ramos, Yanira Burgos, Claudia de Alas, Lorena Parada, Waldemar A. Carlo. Departamento Neonatologia, Hospital Nacional de Ninos, San Salvador, El Salvador; Gerencia del Nino, Ministerio de Salud Publica y Asistencia Social, San Salvador, El Salvador; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.:Impact of a Country-Wide Implementation of the Neonatal Resuscitation Program Abstract 2412