2 May 2012

Africa: Simple Interventions Could Save Most Premature Babies

Photo: Bill & Melinda Gates Foundation
Stunningly small A newborn lies on his mother’s chest. Low birthweight babies often weigh less than two pounds – about five pounds lighter than the average for healthy babies in high-income countries.

More than a million premature babies die worldwide each year, but the majority could be saved if a range of existing inexpensive treatments and procedures were made more widely available, according to a report released today.

'Born Too Soon: The Global Action on Preterm Birth' - produced by a partnership of health organisations including the WHO - estimates that 15 million babies are born prematurely each year.

More than 80 per cent of preterm births occur between 32 and 37 weeks of pregnancy, and with better newborn care, the majority would survive, the report says.

Joy Lawn, a contributing author to the report, told SciDev.Net that up until now "we didn't know how many lives could be saved with really achievable interventions".

The report recommends four simple interventions which could be implemented with relative ease in the developing world, noting that more than 60 per cent of preterm births occur in Africa and South Asia.

Firstly, it suggests that infections could be treated with widely available antibiotics that do not need refrigeration. Use of the antiseptic chlorhexidine on the umbilical cord after birth could also reduce deaths from infection by 20 per cent.

A third intervention would involve administering antenatal steroids, an injection given to mothers at risk of preterm labour. This costs less than a dollar per injection but could save nearly 400,000 lives a year by helping to mature the unborn baby's lungs and reduce the risk of breathing problems.

Finally, the report notes that 'kangaroo mother care (KMC)', where babies are kept warm by being wrapped skin-to-skin in front of their mothers, could also save 450,000 lives a year.

In most cases, for babies born between 28 and 34 weeks it is "superior to incubator care" according to Lawn. "The baby's temperature is much more stable ... Infections go down, weight gain goes up."

However, Lawn warned that a successful expanded rollout of KMC might require training for newborn care providers.

In Malawi, which has the highest preterm birth rates per 100 births, ward attendants were trained in KMC and preterm death rates have since dropped, said Lawn.

Report contributor Lale Say, an analyst for the WHO, said that the UN Millennium Development Goal 4 - which aims to reduce mortality rates in under-fives by two-thirds between 1990 and 2015 - will not be met unless newborn deaths are reduced.

"In places where child mortality is reducing, the reduction is more after the newborn period [the first 28 days after birth]. It has been more difficult to reduce deaths [in newborns]," she said.

The report also recommends ways to reduce premature births in the developing world.

There is a need "to address family planning needs to avoid short time gaps between birth [and to] screen and manage infections like HIV, malaria, and syphilis," Say told SciDev.Net.

Link to full report [5.78MB]

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