World Prematurity Day: A baby born alive before the completion of 37 weeks of pregnancy is called premature birth. When a baby is born after a gestation period of less than 28 weeks, it is called extremely premature. A baby born after 28 to 32 weeks of pregnancy is called very premature. A baby born after 32 to 37 weeks of gestational age is said to be moderately to late preterm.
Asia and sub-Saharan Africa are the regions where most preterm births occur.
According to the World Health Organization (WHO), approximately 15 million premature babies are born every year.
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In 2019, 900,000 babies died due to premature birth. Premature birth is a leading cause of death in children under five years of age.
Even if babies born prematurely survive, they face lifelong disabilities, including vision and hearing problems and learning disabilities.
In low-income countries, up to 50 percent of infants born before 32 weeks die due to lack of viable, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties.
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However, in high-income countries, survival rates are much higher.
Middle-income countries have sub-optimal technology, resulting in an increased burden of disability on premature infants.
In low-income countries, more than 90 percent of premature babies die within the first few days of life, and in high-income countries, less than 10 percent of premature babies die. Is.
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Prevalence, and survival rates of preterm birth in India
India has the highest number of premature deliveries in the world, accounting for about 22 percent of all premature deaths globally. Although the incidence of premature babies varies every year, about 12 to 13 percent of babies born in India are born prematurely.
“India tops the list of countries with the maximum number of preterm deliveries. This accounts for approximately 22% of total preterm deliveries worldwide. About 12% of babies born in India are born prematurely, the incidence varies every year. Dr. Saurabh Khanna, lead consultant of neonatology and pediatrics at CK Birla Hospital, Gurgaon, told ABP Live.
Gestational age is one of the most important factors determining the survival rate of premature babies. The lower the gestational age, the lower the chances of survival of a premature baby.
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If premature babies born after 24 to 26 weeks of pregnancy get good medical care, their survival rates are as high as 80 percent. If the gestational age is more than 28 weeks, the chances of survival are about 90 percent.
“The survival rate of premature babies depends on many factors, of which gestational age is the most important. The survival rate is directly proportional to the gestational age, meaning the more premature the baby is born, the less likely it is to survive. If premature babies are in the care of expert hands, the chances of survival for those born after 24 to 26 weeks of pregnancy can be as high as 80%. “The survival rate once the gestational age crosses 28 weeks is approximately 90%.” Dr. Khanna said.
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However, the survival rate of premature babies in India averages 70 to 76 percent, while in the United States it is 80 to 90 percent.
“The average survival rate of premature babies in India is 70-76% and in the US it is 80-90%.” Dr Narendra Kumar Jha, senior consultant, department of paediatrics, Max Hospital, Vaishali, told ABP Live.
Due to advances in health care and neonatal intensive care services in India, millions of premature babies survive, According to Dr. Khanna.
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risk factors for premature birth
Risk factors for premature birth are twins, pregnancy with triplets or more, use of assisted reproductive technologies, prior premature birth, interval of less than six months between pregnancies, multiple miscarriages or abortions, uterine , problems with the cervix, or placenta, high blood pressure and diabetes in the mother, infections in the amniotic fluid and lower genital tract, injury or trauma, being overweight or underweight before pregnancy, domestic violence, smoking cigarettes, taking illegal drugs, etc. Going through stressful events. Or drinking heavily during pregnancy, and getting pregnant before age 17 or after age 35, according to the Mayo Clinic.
Blacks and Indigenous peoples in the United States are most vulnerable to premature birth.
Risk factors are obesity, high blood pressure, diabetes, anemia, teenage birth, short stature, stress, and domestic violence. To reduce mortality and morbidity, WHO has introduced recommendations for primary care, which have been adopted in Indian hospitals. Dr. Jha said.
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World Health Organization recommendations for the care of premature infants
The World Health Organization (WHO) has given 25 recommendations for the care of premature or low birth weight babies. These can be categorized as preventive and promotive care, care for complications, and family involvement and support.
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Kangaroo care is a type of preventive and promotive care recommended by WHO.
According to the US National Institutes of Health (NIH), kangaroo care is used to treat premature babies after birth. It is the practice of skin-to-skin contact between the infant and the parent.
According to WHO, the baby is kept on the breast of an adult, usually the mother, for a long time. Babies weighing less than two kilograms, who have no other serious problems and are breathing well and have a normal heart rate, can undergo kangaroo care.
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An estimated 450,000 premature babies are saved each year with the help of kangaroo care.
When kangaroo care is used in developing countries, it has been shown to reduce mortality, serious illness, length of hospital stay, and infections, and for premature babies in high-income countries. It is beneficial.
Premature infants who received kangaroo care during their hospital stay showed cardiorespiratory and temperature stability, better neurodevelopmental outcomes, better modulation of pain responses, and better sleep organization and duration of quiet sleep.
Kangaroo care ensures frequent breastfeeding.
Premature babies born after 26 weeks’ gestational age, including those on ventilation, do not suffer any adverse effects on physical stability after receiving kangaroo care.
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Kangaroo care is also beneficial for the mother as she displays increased attachment behavior.
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