Abstract
Specialty care for preterm and critically ill infants has evolved over many years. Neonatal intensive care nurseries were developed, and physicians and nurses learned how to provide intensive care for these infants. Neonatal and maternal (in utero) transport to tertiary centers became common in regionalized systems of care to facilitate the specialized care of high-risk neonates when childbirth occurred in settings without specialized personnel or equipment. Annually, nearly 70,000 neonatal transports occur in the United States. Although specialty care helps reduce rates of neonatal mortality, racial disparities and disparities between urban and rural areas exist. The purpose of this article is to review the progress achieved in neonatal and maternal transport over the past 50 years. The knowledge developed can be used to improve the care provided to women, their fetuses, and infants.
Highlights
In 1971, the estimated neonatal mortality rate in the United States was 14.3 per 1,000 live births; the rate for White infants was 12.9, and the rate for “all other” infants was 20.8 (Wegman, 1972)
The purpose of this article is to trace the development of regionalization and the transport of infants to designated centers, methods of transport, specialized care needed during transport, safety, and associated problems and legal issues
In 2018, the neonatal mortality rate was 3.78 per 1,000 live births (Ely & Driscoll, 2020), a significant decrease that attests to advances in health and the care provided to infants
Summary
In 1971, the estimated neonatal mortality rate in the United States (death at younger than 28 days) was 14.3 per 1,000 live births; the rate for White infants was 12.9, and the rate for “all other” infants was 20.8 (Wegman, 1972). In 2018, the neonatal mortality rate was 3.78 per 1,000 live births (Ely & Driscoll, 2020), a significant decrease that attests to advances in health and the care provided to infants. Racial disparities still exist (see Table 1), and mortality rates vary in relation to urbanization. Advances in perinatology and neonatology as well as the training of neonatologists, neonatal nurses, and neonatal nurse practitioners (NNPs) provide the expertise to care for high-risk neonates and infants
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