JIHEE (MARIE) PARK
<Staff Writer>
November 17th was World Prematurity Awareness Day. It may have been a singular date to give a moment to think about one of the leading causes of neonatal mortality and increased risk of a multitude of neurological, cardiovascular, and other conditions. However, the issue is always there, and so it is of import to be aware of the subject. This article may help you understand the basics, statistics, and gravity of this affliction that carries such great emotional, financial, and political weight.
With contributions from almost 50 international organizations, the WHO’s Born Too Soon Report is the first time that a holistic comparison has been compiled at the international level. The report shows preterm birth rates of countries, trends, and proposals for programs and policies to help the plight of reported rising rates of preterm births.
As a global total, 15 million preterm births were reported in 2010, and rates are rising. Though 75% of deaths of premature babies could be prevented with reasonable and effective care, 1.1 million babies died in that year from preterm complications.
As a national perspective, Canada’s total of 383,100 live births reported a preterm birth rate of 7.78%, or 29,800 preterm babies, an annual change of 1.01%. Of these births, 600 died of complications.
An alarming epidemiological trend reported is that of the 11 countries where over 15% of babies are born too early, 9 are in sub-Saharan Africa. This is likely a result of the higher incidences of various intrauterine infection, HIV, malaria, and poor nutrition. Another surprising finding is that the rate of preterm births in the United States has risen to 12.03%, a high number considering the preconception of a higher standard of medical care and lower rates of infections. However, due to adequate neonatal care of preterm babies, the mortality rate is significantly lower in proportion to other nations of similar preterm birth rates.
Research in this field is substantially difficult, as premature labour is not necessarily an unnatural occurrence, and is influenced by myriad contributing factors. In fact, the causes of near 50% of all preterm births are never known, but some identifiable culprits are proposed to be behind a good portion of them: fetal endocrine activation, placental abruption, decidual bleeding, and intrauterine infection.
Medical terminology aside, these can be understood to be conditions arising from the part of the fetus and/or the mother that causes an abnormality in pregnancy leading to an early initiation of labour. A preterm baby is defined as being under 37 weeks of gestational age. The dangers of preterm birth arise from the fact that an average human fetus undergoes a crucial stage in the development of organ systems from weeks 34 to 37, and, beyond this point, reaches adequate maturity to survive outside the womb. The pulmonary system is one of these crucial systems insufficient in premature babies, requiring the use of ventilators upon premature birth until their lungs are capable of operation.
Proposals for educational programs and changes in policies include informing women of the risk of smoking, and the importance of proper nutrition and prenatal screening to identify uterine infections. These should not only help in improving preterm birth rates, but also for the general health and well-being of all pregnant women.
The care for preterm babies is, in many ways, effective and available. For example, UN experts say that simple and inexpensive antiseptic creams to prevent infection, steroid injections to help fetal lung development, and antibiotics to control infections, can help preterm babies survive. The real issue is the accessibility of these simple treatments. Dr. Howson from March of Dimes, a collaborating charity for the report, said that 90% of preterm babies in low-income countries do not live beyond the first few days, while in high-income countries, only 10% of preterm babies will die of complications.
Like health care in general, inequalities in distribution of care are high across the world. But, as your correspondent sees it, ignorance is the greatest enemy and inaction is the deadliest weapon. As we train an eye to see the wrongs in the world, with a curiosity and passion to back our actions, we can help change the world one step at a time.