by: posted Thursday, May 10, 2012
Babies born in wealthier countries generally stayed in the womb longer.
But the rate of prematurity in the United States remains high, at more than 12 percent of live births. That's about 5 percentage points higher than in Russia, China and Canada and similar to rates in Kenya, Thailand and India.
Some of the 500,000 early births in the United States each year can be explained by the increase in the number of women who opt to have children later in life or undergo fertility treatments -- problems of a well-educated, health-care-rich country. Planned Caesarean sections also contribute to the numbers here, as do high rates of obesity.
But much of it also can be blamed on the same obstacles faced by pregnant women in third-world nations: no access to family planning and no care or inadequate care before and during pregnancy.
The authors of "Born Too Soon ," a new report on premature births, stress that too many babies are born early worldwide and that prematurity rates are increasing in most places.
They call for research to better understand the causes. They seek new prevention strategies and better care for women regardless of their homeland or their income.
The report was written by a group of 45 experts from 11 countries and was led by the March of Dimes, the Partnership for Maternal, Newborn & Child Health, Save the Children and the World Health Organization.
Each year, 15 million premature babies are born worldwide, according to the report. That amounts to 1 in 10 babies. More than a million children die each year because of complications of prematurity. Those who survive often do so with developmental disabilities and other problems.
The report's authors estimate that three-quarters of the 1.1 million deaths each year could be averted if simple, cost-effective interventions were made available to all women, said Christopher Howson, vice president of global programs for the March of Dimes Foundation.
Those include steroids given to women in preterm labor to help babies' lungs develop and so-called kangaroo care, in which mothers (and fathers) have frequent skin-to-skin contact with premature babies.
Kangaroo care keeps the baby warm, promotes frequent breastfeeding, ensures supervision of the infant and helps prevent infections, Howson said. It alone could save an estimated 444,000 lives, the report's authors say.
"It's not even complicated care, or high-tech care or care that requires pediatricians or neonatologists to be highly skilled," said Dr. Mark Klebanoff, a pediatrician and epidemiologist at Nationwide Children's Hospital. Klebanoff was one of several experts who reviewed the report before it was published.
"People haven't been realizing how important the problem is globally," said Hannah Blencowe, a researcher at the London School of Hygiene and Tropical Medicine.
About 8 in 10 deaths to premature babies occur in Africa and southern Asia.
"At the global level, there's this widespread perception that prematurity is not the major problem," Klebanoff said, "that the major problem is the death of full-term children from things like diarrhea and typhoid fever and malaria."
In reality, prematurity is the second-leading cause of death for children younger than 5. Pneumonia kills more.
Elizabeth Mason, director of the World Health Organization's department of maternal, newborn, child and adolescent health, said it's important that researchers look for individual causes of neonatal death, rather than lumping all of them into the same category. Better evaluation of the causes could lead to better interventions, she said.
In central Ohio, health-care providers are working together on the issue of prematurity through the Better Births Outcomes Collaborative. A program to give high-risk women progesterone shots to prevent premature birth or miscarriage has been a particular success story.
FULL SOURCE: www.chicagotribune.com/news/sns-mct-too-many-babies-being-born-too-soon-20120503,0,6903098.story