World Prematurity Day: Born Too Soon
“All newborns are vulnerable, but preterm babies are acutely so.” – UN Secretary, General Ban Ki-moon
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16 November 2018
“All newborns are vulnerable, but preterm babies are acutely so.” – UN Secretary, General Ban Ki-moon

This Saturday, we commemorate the World Prematurity Day to raise an awareness of this serious health crisis. According to the released report Born Too Soon: The Global Action Report on Preterm Birth, of 15 million newborns all over the world, there are more than one in 10 births who are born too early each year. More than one million of those newborns die shortly after birth, while countless others suffer some type of lifelong physical, neurological, or educational disability.

Low birth weight (<2.5 kilograms at birth) due to prematurity and/or restricted growth in uterus, is one of the major contributors of newborns’ deaths, as well as disability. According to the Partnership for Maternal, Newborn & Child Health, India is the country with greatest number of preterm birth, followed by Indonesia at 5th place. This news is somehow very dreadful and saddening for us to hear.

All preterm births are not the same. Preterm are defined as 37 weeks of completed gestation or less, which is the standard WHO definition. Preterm newborns are defined in 3 categories:
  • Late preterm: those born between 32-37 weeks. Most survive with supportive care.
  • Very preterm: those born between 28-32 weeks. Require extra supportive care. Most will survive.
  • Extremely preterm: those born before 28 weeks. These newborns require the most intensive, expensive care to survive. In developed countries, 90% of these newborns will get a chance to survive, though they may suffer lifelong physical, neurological, and learning disabilities. In low-income countries, only 10% survive.

People tend to associate preterm with high-cost intensive care services, which would be challenging to poor countries. However, experts at the United Nations, medical institutions and field organizations say that low-cost, proven forms of care from premature newborns could save at least 3/4 of these newborns in the developing world. These include:
  • Antenatal steroid injections for mothers in premature labor. This helps develop immature fetal lungs and prevent respiratory problems.
  • “Kangaroo care” where the infant is held skin-to-skin on the mother’s chest to keep warm. Kangaroo care makes frequent breastfeeding easy and provides constant maternal supervision for the newborns.
  • Antiseptic cream to prevent birth cord infection.
  • Antibiotics to prevent and fight infection, an important cause of neonatal death.

More effort is needed to identify women at risk of preterm labor and support them to give birth in a health facility that can offer extra care when needed, such as support for adequate feeding with breast milk, continuous skin to skin contact, antibiotics, and antenatal steroids (medications given to pregnant women expecting preterm delivery).

The key way to reduce preterm numbers is to help all pregnancies go to full term (39 weeks). A few risk factors for preterm birth have been identified, including a prior history of preterm birth, under/overweight, diabetes, hypertension, smoking, infection, maternal age (either under 17 or over 40), genetics, multi-fetal pregnancy (twins, triplets, and higher), and pregnancies spaced too closely together.

It is important that families, communities and health care workers value newborns so that they receive the life-saving care they need. All health care providers, including physicians, nurses, and midwives, need training in basic preterm care, because there are so many situations where even the doctor doesn’t seem to know what to do with a tiny infant.
 

Solutions to improve the survival and health of vulnerable preterm and low birth weight newborns exist. Essential newborn care as well as basic care for feeding support, infections, and breathing difficulties can mean the difference between life and death for newborns. Please visit our neonatal related solutions here: https://www.idsmed.com/id-en/product/1/all/og-and-peri-natal_99/all/
 
 
 
 
References:
https://reliefweb.int/report/indonesia/indonesia-profile-preterm-and-low-birth-weight-prevention-and-care
http://www.who.int/pmnch/knowledge/publications/preterm_birth_report/en/index3.html

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