Premature birth: leading cause of death for children under 5
According to a recent study published in The Lancet, complications from preterm birth accounted for more than 1 million deaths in 2013, surpassing pneumonia as the leading cause of under-5 child mortality in the year. Nearly a million of these deaths took place within the first month of life, with the remaining 125,000 deaths taking place before age 5. Many other premature babies who survive face a lifetime disability, including learning disabilities and visual and hearing problems — often at great cost to families and society.
14 out of 100 babies born prematurely in Bangladesh, more than the global average! Bangladesh is among the 10 countries with the highest numbers of children under-five dying from preterm birth complications. Preterm birth complications are the leading cause of death in newborns and accounts for 45% of all newborn deaths in Bangladesh which was 36% in 2000.
These figures should indicate an urgent call for concerted action. Dr Sayed Rubayet, Project Director of Saving Newborn Lives (SNL) of Save the Children said that tackling premature birth complications is one of the greatest health challenges the world is facing. However, the awareness and interventions to prevent and treat complications related to premature births are still very poor and needs to move higher up on global agenda.
He also added that many people think that preterm babies need intensive, high-tech care, but we have simple methods such as warmth, breastfeeding support, basic care for preventing infections and breathing difficulties, that could reduce the deaths by over three-quarters, even without the availability of costly neonatal intensive care.
Among the interventions — Kangaroo Mother Care (KMC), antenatal steroid injections (when indicated), antiseptic cream to prevent cord infection and antibiotics to fight infections are particularly important.
In KMC, mothers serve as human incubators for their newborns where the infant is held skin-to-skin on the mother's chest to keep warm. This low cost, highly effective technique has the potential to save millions of babies born too soon and also reduce the need of costly incubators. But the service is not available throughout Bangladesh and thus, it is crucial to make it available.
Antenatal steroid injection called corticosteroid is a low cost drug that helps develop immature fetal lungs and prevent respiratory problems and is particularly indicated for women before 34 weeks of pregnancy.
To prevent infection in newborn, a simple antiseptic named Chlorhexidine (7.1%) application on umbilical cord can reduce neonatal infection and mortality significantly.
This is particularly important for a country like Bangladesh where many infants are born at home, deliveries are often conducted by unskilled birth attendants and care provided during labour, delivery along with the immediate postnatal periods are often unhygienic or include harmful practices. In addition, simple antibiotics can save lives, such as amoxicillin and gentamycin to treat newborn infections.
In order to help reduce preterm birth rates, family planning and increased empowerment of women, especially adolescents, plus improved quality of care before, between and during pregnancy, strategic investments in innovation and research are also crucial.