Premature babies born in Monaghan and Dundalk hospitals have a greater morbidity and mortality, according to figures seen by The Irish Times.
A study by Dr Alf Nicholson, consultant paediatrician at Our Lady of Lourdes Hospital in Drogheda, where the majority of sick new-born babies are transferred, shows that their outcome in terms of dying and length of stay in special care is "very definitely prejudiced."
The figures give added urgency to the debate concerning the future of the maternity units in Monaghan and Dundalk.
Both units have a single consultant obstetrician and no paediatric services. They are the only such units either here or in the UK.
This means that babies who have breathing difficulties (asphyxia) at birth and those born at less than 32 weeks' gestation are denied the expert skills required to resuscitate them. It places them at risk of severe physical and mental handicap and even of death.
The study looked at all neonatal transfers from the Louth County Hospital and Monaghan General Hospital to Drogheda for the years 1990, 1992, 1994, 1996, 1998 and 2000. It found an increasing number of transfers over this period, from nine in 1990 to 34 in 2000.
Up to three premature babies and two full-term babies who are unable to breathe at birth are transferred to Drogheda each year.
Since 1995, and despite the best efforts of the medical and nursing staff in both Monaghan and Dundalk, four babies have died of asphyxia and two premature babies have also not survived.
In 2000 three infants under 28 weeks' gestation had to spend prolonged periods on ventilators following their transfer. One of them remains in hospital with a severe brain haemorrhage.
An external expert group, appointed by the North Eastern Health Board to examine the future of the Monaghan and Dundalk obstetric units, recommended in November that consultant-led obstetric services cease at both hospitals.
While it was accepted by the health board executive and most medical representatives, the recommendation was rejected by a majority of the politicians on the board.
They have voted for a motion seeking to appoint up to 12 extra temporary consultants to Dundalk and Monaghan.
However, with only 550 deliveries a year in Dundalk and 330 in Monaghan it is difficult to justify the addition of two consultant obstetricians, three consultant paediatricians and an extra anaesthetist to each hospital.
Dr Peter Wahlrab, a Kells general practitioner who resigned from the NEHB in protest at the decision to seek funding to upgrade the two maternity units, told The Irish Times: "This is a totally irresponsible attitude in a board which is short of resources and has hospitals which do not meet any sort of conventional standards, and have no services in such areas as urology, ENT, opthalmology, dermatology and microbiology.
"We are deficient in such a wide range of essential services for people who have serious life-threatening illnesses, yet we are now talking about taking well women and allocating all the resources to them for political advantage," he said.
The North Eastern Health Board has also been told by its insurer, the Irish Public Bodies Mutual Insurances Ltd, that indemnity cover for the two obstetric units will be withdrawn at the end of February, "unless appropriate interim measures are implemented in the immediate future, pending a final resolution of the overall problem by the board".
Commenting on his study, Dr Nicholson said that in the last 10 years there had been evidence to support the statement that where babies were delivered without on-site paediatric back-up their outcomes were definitely poorer.
"Dundalk and Monaghan have dedicated midwives, obstetricians and anaesthetists, but if a baby is in difficulty at birth it will suffer because of the lack of paediatric expertise. A single unavoidable death or baby with handicap is not acceptable", he said.