Neonatal Mortality in Finland Remains Low Despite Small Delivery Units

Finland continues to be a global leader in neonatal care, demonstrating remarkably low neonatal mortality rates even as the number of hospital deliveries has decreased due to the country's declining birth rate. Recent research from the University of Eastern Finland, encompassing three large-scale studies, highlights that flexible distribution of deliveries across smaller maternity units does not compromise neonatal safety.

The first extensive registry study, analyzing data from over 800,000 live births between 2008 and 2023, revealed a significant decline in neonatal mortality, especially among preterm infants. Importantly, the study found no direct link between a hospital’s annual delivery volume and neonatal death rates, suggesting that safe delivery outcomes are achievable even in smaller hospitals when appropriate care protocols are followed.

A second study focused on twin pregnancies confirmed that neonatal mortality among twins has also decreased substantially over the years, with rates as low as 0.09% for full-term twins and 0.46% for preterm twins in recent data. Despite a slight rise in the need for intensive care among these infants, hospital stays have become shorter, indicating improvements in prenatal diagnostics and neonatal management.

The third research compared outcomes in small units handling fewer than 1,000 deliveries annually with larger tertiary hospitals. While mortality during or after birth was similar, preterm infants in smaller units showed a marginally higher mortality rate. Nonetheless, the overall mortality in these small units remains among the lowest globally, reflecting effective risk assessment and delivery practices.

These studies, based on comprehensive Finnish Medical Birth Register data, support current policies that centralize high-risk deliveries to specialized university hospitals. However, they suggest that small delivery units are capable of providing excellent neonatal outcomes, challenging the notion that only large hospitals can ensure neonatal safety.

Overall, Finland’s neonatal care system exemplifies that high-quality outcomes can be maintained across diverse hospital settings, even amidst reductions in delivery volumes, thanks to standardized protocols, effective training, and regional cooperation.