Official: Mortality Rate for Small Preemies Double the Western Average

The mortality rate for very small premature babies in Israel is almost double the average in the West, the chairman of the Israel Neonatal Society said yesterday.

"Here in Israel, we can treat preemies born weighing 800 grams or more," said Prof. Shaul Dollberg, who also runs the neonatal ward at Ichilov Hospital in Tel Aviv, as the Knesset's Labor, Welfare and Health Committee was touring the neonatal unit of Schneider Children's Medical Center in Petah Tikva. "But when it comes to preemies weighing 500 to 600 grams, most of them die - whereas in the United States, Europe and Japan, about 50 percent of those preemies survive."

A report published in November 2010 by the Gartner center and the Health Ministry found there has been some improvement in recent years: Over the decade ending in 2008, the mortality rate for preemies weighing up to 750 grams dropped by 6.8 percent. But according to the neonatal society, a professional organization for Israeli neonatologists, mortality rates are still substantially higher than the Western norm.

In 2008, for instance, only a single Israeli preemie weighing less than 500 grams at birth was still alive a month later, out of the 24 born. Of the 54 preemies weighing between 500 and 600 grams at birth, only 13 survived, for a mortality rate of 76 percent. And of the 103 weighing between 600 and 700 grams, 42 survived, for a mortality rate of 59 percent.

One major reason for this is that 26.7 percent of Israeli preemies weighing less than 1.5 kilograms at birth develop sepsis. That figure represents a 30 percent decline since 2005, but it is still about 50 percent more than the rate in the U.S. and Western Europe. Preemies weighing less than 1.5 kilograms account for about 1 percent of all Israeli births.

"We have the knowledge to treat small preemies here as well, but we don't have the resources," Dollberg said. "The statistics derive mainly from infections due to a lack of manpower."

Such infections even periodically force neonatal wards to close: Between August 2008 and May 2010, ministry statistics show, various neonatal wards were closed for a total of 78 days. Of the 26 hospitals with neonatal wards, five accounted for 74 of these lost days: Assaf Harofeh, Sheba, Kaplan, Laniado and Schneider.

In December, a professional panel set up by the Health Ministry determined that in light of the rise in premature births, Israel's neonatal wards needed another 89 doctors and hundreds of additional nurses, along with 240 additional beds. Every year, the number of hospitalized preemies increases by about 10 percent, and is currently about 1,600 a year.

The Health Committee tour was mainly aimed at giving MKs a close-up view of this manpower shortage. The state comptroller criticized the overburdened state of the neonatal wards as far back as 2004, but so far, nothing has been done.

Last week, however, the cabinet agreed to add 960 hospital beds over the next six years. The Health Ministry is planning to allocate 40 of these beds per year to the neonatal wards, in line with the professional committee's recommendations.

In addition, the Finance Ministry is currently negotiating a new wage agreement for public-sector doctors with the Israel Medical Association. The neonatal society is urging the government to use this opportunity to encourage more doctors to go into neonatology by offering higher wages.

Israel currently has 119 neonatologists. But 29 are due to retire in the next five years, whereas last year, only one new neonatologist was certified.