[The medical care of newborn infants in Switzerland].

Switzerland has one of the lowest neonatal mortalities in the world (5%) which has barely decreased during the last 10 years. The aim of care for newborn infants has therefore shifted from reducing mortality to reducing morbidity and increasing quality of life. Diseases which were frequent and severe some twenty years ago, such as rubella embryopathy and rhesus incompatibility, have almost disappeared today due to general prophylaxis. On the other hand, new, partly iatrogenic diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia, considerably affect present morbidity of newborn infants. Due to newly developed imaging techniques and genetic, biochemical and immunological methods for screening of risk groups or all pregnant women or newborns, more and more diseases are detected earlier. Therefore the optimal procedure has to be settled early and on an interdisciplinary basis, and include prenatal investigation and possibly treatment, planning of delivery, and early and late postnatal diagnostic and therapeutic measures. The consequence of this development is close cooperation between obstetricians, neonatologists, and pediatric specialists, and a rapidly increasing need for neonatal beds, especially for intensive care. In spite of identification and centralization of women with high risk pregnancy before delivery, every newborn may develop sudden, unpredictable problems of adaptation which need immediate action. Therefore, at every delivery in a clinic or at home the necessary equipment and skilled staff must be available in order to cope with acute problems during adaptation from intrauterine to extrauterine life.