A Reason To Celebrate
The McMaster Neonatal Unit opened on February 9th 1973, with three physicians: Dr. Jack Sinclair, chief of the division; and neonatologists, Drs. Chap Yeung and Saroj Saigal; seven neonatal nurses*; and a handful of support staff. To start the unit, five premature infants were transported from Henderson Hospital neonatal unit. The McMaster unit became busy quickly and within nine months had reached its capacity of 28 beds. Concurrently, Dr. Sid Effer established the high-risk obstetric unit, so that mother and infant care could be centralized in the region of central-west Ontario. It was this unit, the first of its kind in Canada, that became the model for regionalization of perinatal intensive care.
Birth Weight and Survival
In that era, survival of infants less than 1500g birth weight was around 60%, but for infants below 1000 g it was only 10%. With the opening of the McMaster Neonatal Unit, survival began to improve substantially. By 1977-1980, survival of infants below 1000g had risen to a remarkable 55% for those treated in the unit. Today the survival of infants less than 1500g birth weight is greater than 90%, and more and more immature and smaller infants are surviving. The NICU has grown to 48 beds with a large, dedicated team of neonatologists, neonatal nurses, nurse practitioners and neonatal fellows.
Growth and Development Clinic
From the outset, the Growth and Development Clinic was established to monitor the neurological and developmental progress of high-risk infants, and to provide support and reassurance to parents. Dr. Saroj Saigal ran the clinic since its inception, and Dr. Peter Rosenbaum, a developmental pediatrician, joined later that year. At the time, very little was known about the longer term neurological, cognitive and behavioural outcomes of very low birth weight infants at school age and beyond. Through the work in this clinic and many other centres in the world, we are now more informed about the long-term implications of prematurity, and the reports are generally reassuring. (Pictured Above: Drs. Saroj Saigal and Jack Sinclair, 1973)
One of the major strengths of the McMaster neonatal program is its emphasis on evidence-based medicine. Dr. Sinclair edited one of the first books in the field of medicine on evidence-based neonatal care that is widely cited. In addition, the unit attracted international fellows from all over the world. Graduates of the fellowship program have since occupied leadership positions in almost every province of Canada and in a dozen other countries, particularly the USA, Australia, New Zealand, the United Kingdom and Ireland. The unit is also known for its innovative research in neonatal care, clinical trials and long-term outcomes of its preemie graduates.
(Pictured Above: 2009: Jack Sinclair, Saroj Saigal, John Watts, and former fellows, Jon Tyson (’73-75) and Ed Bell (’76-77), at the AAP Meeting.)
*Barb Stoskopf, Nancy Gordon, Sherry Thorne, Wendy Lewis, Sandy Noble, Irene Chen and Aurora Ditoro (Aurora is the only one who is still working in the NICU).
Pictured Below: Neonatal Unit, 1973 (left), and the new unit, 2001 (right):