Introduction
Neonatal medicine has advanced considerably in the last four decades. In the United Kingdom, neonatal mortality (Table 37.1) has fallen from 6.3 per 1000 live births in 1982 to 2.7 per 1000 live births in 2014, a reduction of approximately 60% (1).
However significant global challenges remain. In 2015, neonatal deaths accounted for 45% of all deaths in children under 5 years, of which 80% were related to preterm birth, infection, or perinatal asphyxia (2). Neonatal medicine continues to evolve rapidly; by the time this textbook is published, many currently accepted wisdoms may have altered. This is of course the nature of medicine, as with hypothesis testing, never seeking absolute truth, but only ever decreasing uncertainty. This chapter will help practitioners anticipate problems, understand the basic principles of newborn care, recognize common newborn problems, and understand the importance of improving newborn services. In doing so, there is emphasis on the importance of (a) having a clear understanding of basic principles that will stand the practitioner in good stead whatever the circumstances, (b) continually questioning accepted wisdoms, and (c) implementing best practice and evaluating outcomes.
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