Germany suspends decision to stop some hospitals treating very low birth weight babiesBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d156 (Published 10 January 2011) Cite this as: BMJ 2011;342:d156
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Weight is an important factor for the survival of neonates and
infants.During the first 12 weeks of gestation, the weight of the fetus is
almost insignificant. The fetus attains a weight of around one pound only
at 23 weeks gestation. After this period, the fetus weight grows rather
rapidly. The average infant weight at birth after a normal gestation
period is around 7.0 pounds. This weight; however; varies between 4.5 to
11.0 pounds. The immature development of the organ system and/or non-adaptability of hormonal or neurogenic control systems in neonates may
lead to instability of this control; ultimately resulting in problematic
functioning of many organ systems (particularly respiratory and
circulatory systems) in neonates. It is a well recognized fact that the
premature infant has immature organ systems which require utmost and
critical attention. Respiratory distress syndrome, poor fat absorption,
rapid onset of anemia, high risk of hepatobiliary disorders (such as
jaundice), hypothermia, immunity problems, allergies etc pose serious
threats to the survival of premature neonates. These complications require
constant monitoring of the physiological systems and a physician has to
frequently resort to oxygen therapy, low-fat diets and other life-saving
modalities which require a considerable expenditure . Low-birth weights
are not much unusual. low birth weight babies are categorized into two
groups - one having a low birth weight because of pre-term birth and ones
having birth weight inconsistent with their gestational age . The
survival rates for the very low birth weight infants are quite low .
One can easily imagine that the low birth weight babies will pose real
challenge to the healthcare teams in clinical settings. Many a times;
claims are filed for the post-delivery care of such infants.
It seemed to be unethical when Germany's Federal Joint Committee
(regulator of statutory health insurance companies) tried to restrict the
number of hospitals providing care to such babies. It is good to note that
several hospitals came out against this apparently unethical ruling .
What is even more satisfying is that the protests by these hospitals have
not gone in vain and the ban / ruling has been (temporarily) lifted .
After all, the health and survival of the subjects are more important than
anything else - be it expenses or insurance money.
1. Guyton AC, Hall JE. Fetal and Neonatal Physiology. In Textbook of
Medical Physiology, Eleventh edition (2006), Elsevier Inc, Pennysylvania,
2. Pregnancy website: www.pregnancy-info.net accessed on Jan 19, 2011.
3. E-medicine web resource: http://emedicine.medscape.com/article/979717-
overview accessed on Jan 19, 2011.
4. Tuffs A. Germany limits number of hospitals that care for very low
birth weight babies. BMJ 2010;341:c6881.
5. Tuffs A. Germany suspends decision to stop some hospitals treating very
low birth weight babies. BMJ 2011;342:d156.
Competing interests: Teaching Pharmacy courses at UG and PG level