Preterm birth: an emerging threat to newborn survival
14 out of 100 babies in Bangladesh are born prematurely — before 37 weeks of pregnancy and the rate is rising. Preterm birth complications are now the leading cause of death in newborns and accounts for 45% of all newborn deaths in Bangladesh which was 36% in 2000.
Preterm birth impinges huge challenge to improve newborn survival. Experts said that increasing quality care in pregnancy, strategic investment in innovation and research to prevent premature birth and mass implementation of cost-effective care are essential to save millions of newborn from early grave.
Preterm birth is associated with a number of risk factors and causes. Common causes include multiple pregnancies, infections, diabetes and high blood pressure. A prior history of preterm birth, underweight, obesity, smoking, maternal age (either under 17 or over 40), genetics, twin pregnancy and pregnancies spaced too closely together are also considerably associated. Although most preterm births happen spontaneously, some are due to early induction of labour or caesarean birth.
In addition to avoid or control the aforementioned causes, improving quality care before, between and during pregnancy, strengthening family planning services, increased empowerment of women can help to reduce premature birth rates.
However, studies showed that existing cost-effective interventions such as warmth, breastfeeding support, basic care for infections and breathing difficulties could reduce these deaths by over three-quarters, even without the availability of costly neonatal intensive care.
Dr Sayed Rubayet, Project Manager of Saving Newborn Lives (SNL) and Helping Babies Breathe (HBB) of Save the Children pointed out that there is a dramatic survival gap between high- and low-income countries where half of the babies born at 24 weeks survive in high-income countries; but in low-income settings, half the babies born at 32 weeks continue to die due to lack of inexpensive and affordable care.
He also mentioned that "Kangaroo Mother Care' (KMC) where the infant is held skin-to-skin on the mother's chest to keep warm can reduce the death by half in these babies specially those having low birth weight with almost no cost.
Antenatal steroid injections (which is damn cheap and affordable for poor countries like Bangladesh) to help develop immature fetal lungs and prevent respiratory problems, antiseptic cream to prevent birth cord infection and antibiotics to fight infection are some inexpensive solutions to prevent unnecessary deaths. He also underscored the importance of training front line health workers on dealing with premature babies and help them breathe if any difficulty and recognise timely to refer to specialised care.
Bangladesh is among the 10 countries with the greatest numbers (424100) of preterm births. Addressing the problem properly, strengthening prevention strategy and ensuing inexpensive solutions can give them a second chance to survive.