Tackling preterm birth

The World Health Organisation (WHO) defines preterm birth as babies born alive before 37 weeks of pregnancy are completed. According to the most recent estimates, preterm birth is the leading cause of death in children under the age of five; each year, about 15 million babies worldwide are born preterm, which is about 1 in 10 children. Many survivors face a lifetime of disabilities, including learning disabilities and visual and hearing problems.

In low-income settings, half of the babies born at or below 32 weeks (2 months early) die due to a lack of feasible, cost-effective care such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. Suboptimal use of technology in middle-income settings is causing an increased burden of disability among preterm babies who survive the neonatal period.

Preventing deaths and complications from preterm birth starts with a healthy pregnancy. WHO's antenatal care guidelines include key interventions to help prevent preterm birth, such as counselling on healthy diet, optimal nutrition, and tobacco and substance use; foetal measurements, including the use of early ultrasound to help determine gestational age and detect multiple pregnancies; and a minimum of 8 contacts with health professionals throughout pregnancy, starting before 12 weeks, to identify and manage risk factors such as infections.

In 2022, WHO published new recommendations on the care of preterm infants. These reflect new evidence that simple interventions such as kangaroo mother care (KMC) immediately after birth, early initiation of breastfeeding, and early use of respiratory supports such as continuous positive airway pressure (CPAP) for breathing problems can substantially reduce mortality in preterm and low birthweight babies.

"World Prematurity Day" on November 17 is one of the most important days of the year to raise awareness of the challenges and burden of preterm birth globally, as well as ways to prevent it and how to give babies born too soon the best chance to survive and thrive. The global theme of World Prematurity Day 2023 is "Small actions, big impact: immediate skin-to-skin care for every baby everywhere." Skin-to-skin contact has been proven to be extremely effective for every baby, especially for premature babies.

The writers are Assistant Professor of Neonatology of Abdul Malek Ukil Medical College, Noakhali and Assistant Director of Civil Aviation Authority of Bangladesh (CAAB) respectively. Email: abdullahelamaan@gmail.com, khainoorzahan@gmail.com