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Thursday, May 3, 2012

Half of child deaths due to pre-term births

Pratirodh Bureau

Pre-term birth second leading cause of death among children, says new report.

Nearly half of all child mortality is caused due to pre-term births, a new report by Save the Children titled Born Too Soon: The Global Action Report on Preterm Birth has revealed.
Deaths caused due to pre-term births are second only to pneumonia, the report notes.

In India, 2.7 million pre-term babies are born in India which exposes them to an enormous risk of dying early, often shortly after their birth. India has the 36th highest rate of pre-term birth in the world, and has the last rank among countries rated for deaths due to complications arising out of pre-term birth, this has been revealed in a report, Born too Soon.

Save the Children India CEO Thomas Chandy said that many factors such as early marriage and pregnancy, inadequate nutritional intake by pregnant women and lack of adequate health interventions were among other reasons that contributed to such a high rate of pre-term pregnancy, exposing both the mother and the baby to risk.

Save the Children India Senior Advisor for Maternal, Child and Newborn Health, Dr Rajiv Tandon, said “The problem of premature birth needs both attention and intervention if India is to improve its maternal and child health record.  He informed that Mr Mukesh Ambani and Ms Nita Ambani recently expressed their interest in working in this area through their Foundation’s support to Save the Children. Save the Children

A look at the table below indicates that in terms of deaths due to pre-term birth, India is at the top (indicating it fares the worst) while in terms of the rate of pre-term births, it is at the 36th rank, ahead of Malawi (at the first rank), Pakistan (8) Nepal (20) and Bangladesh (24).

Pre-term births: India and some of its neighbours

Country            Rank for deaths due to complications of preterm birth (2010) Rank for preterm birth rate (2010)

India                              1                                                                                                       36

Pakistan                      3                                                                                                        8     

Bangladesh             6                                                                                                        24
Myanmar                   15                                                                                                      46

Afghanistan           9                                                                                                   66
Nepal                 20

Each year, some 15 million babies in the world, more than one in 10 births, are born too early, says the report.More than one million of those babies die shortly after birth; countless others suffer some type of lifelong physical, neurological, or educational disability, often at great cost to families and society.

An estimated three-quarters of those preterm babies who die could survive without expensive care if a few proven and inexpensive treatments and preventions were available worldwide, according to more than 100 experts who contributed to the report, representing almost 40 UN agencies, universities, and organizations.

The report explains what is known about preterm birth, its causes, and the kinds of care that are needed.

The lead authors of the report from The March of Dimes Foundation, The Partnership for Maternal, Newborn & Child Health, Save the Children and The World Health Organization, offer a detailed plan for the actions needed to reduce both the death toll and the numbers of preterm births. 

Preterm births have been an overlooked and neglected problem, world health leaders say.

“All newborns are vulnerable, but preterm babies are acutely so,” says UN Secretary General Ban Ki-moon, who wrote the foreword to the report and considers the effort to reduce preterm births and deaths an integral part of his Global Strategy for Women’s and Children’s Health.

“Being born too soon is an unrecognized killer,” says Save the Children’s Advocacy and Policy Director Shireen Vakil Miller. “The statistics for India are not in line with its economic status in the world. India needs to improve its public health system immediately and urgently,” she said.

Joy Lawn, co-editor of the report, said, “Preterm births account for almost half of all newborn deaths worldwide and are now the second leading cause of death in children under 5, after pneumonia.”

The countries with the greatest numbers of preterm births are India - 3,519,100; China - 1,172,300; Nigeria - 773,600; Pakistan - 748,100; Indonesia - 675,700; United States - 517,400; Bangladesh - 424,100; Philippines - 348,900; Democratic Republic of the Congo - 341,400; and Brazil - 279,300.

All preterm births are not the same

For the report, preterm was defined as 37 weeks of completed gestation or less, which is the standard WHO definition.

Prevention key to reducing premature births

A key way to reduce preterm numbers is to find ways to help all pregnancies go to full term, or 39 weeks. A number of risk factors for preterm birth have been identified, including a prior history of preterm birth, underweight, obesity, diabetes, hypertension, smoking, infection, maternal age (either under 17 or over 40), genetics, multi-fetal pregnancy (twins, triplets, and higher), and pregnancies spaced too closely together.

However, little is known about the interplay of these and other environmental and social factors.

The report calls for a strong research program to identify risk factors clearly and understand how their interactions may lead to preterm birth so that more definitive ways can be found to screen and treat women at risk to prevent the problem from occurring.

Until research provides better answers, though, the report advises taking effective measures now, such as screening women for known medical conditions that could put them at risk during pregnancy, assuring good nutrition before and during pregnancy, and making sure that all women have access to good preconception and prenatal health care and receive the recommended number of visits during pregnancy.

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