We retrospectively studied the physical and neurological prognoses of 51 small-for-date infants (SFD) who had been taken care in our faculty during the neonatal period. The values of physical measurements of SFD at one and two years of age were both significantly smaller than those of the controlled appropriate-for-date infants. Majority of infants with symmetrical intrauterine growth retardation, whose head circumferences at birth were under -1.5 S. D., showed many complications during the neonatal period, for example; hypoglycemia and polycytemia, and their neurological prognoses were poorer than those with asymmetrical intrauterine growth retardation. To improve these grave prognoses, we stressed the necessity of the system which can provide strict maternal and neonatal care as well as the continuous observation even during the grownup under the co-operation of obstetrician and pediatrician.

We assessed the pediatric emergency care system of our hospital. A total of about 11,714 children were carried into the emergency room during 1998. Their age was young, 33.6% being less than 4 years old and 54.5% less than 7 years old. About half a number of them (50.8%) were received between 5 p.m. and midnight and 75.3% at night. They came to our hospital from two or three secondary medical care areas, the population of which was estimated at 800,000 including 120,000 children. Twenty-six percent of outpatients and 43% of inpatients were those who had first visited the emergency unit. During the year 110 persons entered into our pediatric ICU, 45 persons underwent mechanical ventilation therapy, and an average of 7.4 patients stayed in hospital per day.We also reviewed the changes of the pediatric emergency care system of our hospital for 20 years. This system has gradually developed. Chronologically, the neonatal intensive care unit was set up in 1983, followed by the opening of the pediatric intensive care unit in 1986, the start of the 24-hour emergency medical care by pediatricians in 1993, the home mechanical ventilation therapy in 1996 and the respite care since 1997. In other words, our system developed from intensive care to primary care and home care—from in-hospital to out-hospital. These changes were the result of our effort to cope with regional features and meet demands : increase of younger children, insufficiency of pediatricians, expansion of medical area in our change and parents’ request for rediatrician’s examination at any time.In summary, an increasing number of patients who need pediatric emergency care tend to concentrate into one central hospital in a large region. Pediatric emergency care developed into general pediatric medicine including primary care and intensive care and home care.
Hospitals ; Emergency Care ; Pediatric ; seconds ; Child