World Prematurity Awareness Month

World Prematurity Awareness Month is observed annually in the month of November.

World Prematurity Day is held on 17th November with the aim of raising awareness on the numerous challenges that preemies face. Preemies is a term that is used to refer to babies born before their due date.  During this month, different stakeholders in this field also raise concern on the huge burden that preemie families carry.

Did You Know…

  • That the World Prematurity Day was first initiated by the European Foundation for the Care of Newborn infants (EFCNI) in 2008, alongside LittleBigSouls, March of Dimes and the National Preemie Foundation. Over the years, many more countries have joined efforts to address preterm births as a serious health issue.
  • The colour purple is used to mark prematurity awareness because it symbolizes sensitivity and the exceptional journey that preemies make to come into this world.
  • The socksline is the symbol for World Prematurity Awareness Month. With this socksline, there is a tiny pair of purple socks flanked by nine pairs of full baby-size socks – to show that 1 in every 10 babies is born pre-term across the world.

World Prematurity Day

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According to this 2018 report by WHO, it is estimated that 15 million babies are born preterm, that is before 37 weeks of pregnancy. Of these babies, more than a million do not survive owing to the health complications that surround a preterm birth.

These statistics are higher in Africa and South East Asia where more than 60% of these births occur. In fact, the report draws a comparison between the percentage of preterm babies in low & middle income countries (LMICs) and higher income countries at 12% and 9% respectively. Within the LMICs, women from low income settings are at a significantly higher risk. These findings have been documented, despite the fact that more than 50% of babies born between 32 and 37 weeks of pregnancy may not  need intensive care for their survival (Source).

Preterm births in Kenya

According to the Every Preemie Scale 2019 report, 134,000 babies are born preterm in Kenya every year. Out of these preemies, 9,670 children below five years will die as a result of complications after birth. As mentioned above, 85% of babies born preterm between the 32nd and 37th week of gestation could do without intensive care, provided there are appropriate medical interventions and other solutions to ensure the health and survival of these vulnerable babies. For preemies, essential care for newborns coupled with hygiene, breathing and feeding is a matter of life and death.

These solutions typically revolve around:

  • Immediate and exclusive breastfeeding
  • Kangaroo Mother Care
  • Care of the cord
  • Hygiene to prevent infections
  • Follow-up to prevent breathing difficulties

More importantly, a lot more needs to be done to educate pregnant women, families and health care workers so that preemies can get the care and support that they need to thrive.

In light of these findings, World Prematurity Awareness Month is dedicated to raising awareness on preterm births as well as the health concerns of preemies and their families. This is also an opportunity for stakeholders in the maternal field to talk about solutions available to reduce the rate of preterm births.

2019 Theme for World Prematurity Awareness Month

The World Prematurity 2019 Theme is: ‘Born Too Soon: Providing the right care, at the right time, in the right place. As mentioned above, 15 million babies are born prematurely every year. This accounts for more than one in every ten babies globally.

Complications arising from preterm birth account for more the deaths of more than a million of these preemies. This makes preterm birth the number one cause of death for children before five years. What’s more, many more preemies who survive these complications face numerous health challenges. Without global attention and efforts to reduce these deaths, it is unlikely that the world will attain the goal to end preventable deaths of newborns and children under 5 years by 2030 (UNICEF).

What is a preterm birth?

A preterm birth is defined as any birth that occurs before the 37th week of pregnancy. The babies born are referred to as preemies. Additionally, there are varying categories of preterm birth as determined by the gestational age.

Read More: Pregnancy Timeline: Here’s what is happening to your body as pregnancy progresses

Different categories of preterm birth

These categories include:

  1. Moderate to late preterm birth – with births that occur between 32 and 37 weeks.
  2. Very preterm birth – with births that occur between 28 and 32 weeks.
  3. Extremely preterm birth – with births that occur before 28 weeks
  4. Micropreemie birth – used to define births that occur before 26 weeks, with babies weighing less than 800 grams.

What are some of the challenges that preemies face?

One of the main reasons why World Prematurity Awareness Month is observed is to bring to light some of the hurdles that preemies face after birth. This not only sensitizes pregnant women, it also helps the society be a little more empathetic when supporting preemies and their families.

While still in the uterus, babies undergo varied growth and development stages that prepare them for life outside the womb. These stages, even in the last trimester/last few weeks of the pregnancy matter. For instance the baby’s liver and brain develop fully in the last few weeks of the pregnancy. The baby’s lungs are also maturing to allow for breathing after birth.

Preemies

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When babies are born before 37 weeks of pregnancy, they face a number of medical challenges. These include:

Respiratory difficulties

Ideally, baby’s lungs are well developed and mature by the 37th week of the pregnancy. This however, may differ depending on the baby’s growth and development in utero. For babies born prematurely, their lungs may not be able to produce adequate surfactant. Surfactant is the substance that helps keep the air sacs in the lungs open. Preemies therefore, are at risk of respiratory difficulties as their tiny lungs cannot take in oxygen and eliminate carbon dioxide.

Staying warm

Preemies tend to lose body heat very fast when compared to full-term babies. This predisposes them to hypothermia and a host of other conditions. For this reason, they require additional energy and care to stay warm and ensure their survival. One of the techniques that has been embraced in healthcare is the Kangaroo Mother Care (KMC). KMC involves skin-to-skin contact between the baby and the parent’s chest to help regulate the baby’s temperature and allow warmth for baby’s growth.

Feeding challenges

Babies born prematurely also experience feeding challenges. This is because the suckle-and-swallow reflex is still underdeveloped. This is why most hospitals with a neonatal unit offer nutrition management to assist parents with feeding their little champions.

Read More: Breastfeeding Awareness Month: How families can support breastfeeding mothers

Infections

Infections are a common occurrence amongst preemies, and that’s because their immune systems are not fully developed. Additionally, preemies typically require medical attention which may involve a number of procedures. Procedures that require insertion into the skin may provide entry for bacteria or viruses, making this one of the biggest challenges that preemies face.

Jaundice

Jaundice is also common in preemies, in particular the exaggerated physiologic type of jaundice. This occurs because the baby’s liver cannot eliminate bilirubin (a byproduct that results when red blood cells are broken down). This leads to the accumulation if bilirubin in the baby’s body, giving their skin the characteristic yellowish coloration. Left untreated, bilirubin build up causes toxicity and brain damage. In most cases however, phototherapy is started to prevent elevated levels of bilirubin.

Effects on the brain

A preterm birth predisposes the baby to bleeding in the brain – during or after birth. In fact, WHO points out that 1 in 5 preemies born weighing below 2kgs are at a higher risk of bleeding in the brain. In addition to this, the lack of oxygen in the brain may lead to long-term medical complications such as cerebral palsy and developmental disabilities.

Conclusion

More than 75% of preemies born can be saved through effective, practical cost-effective care. The prevention of complications that arise during and after this birth begins with quality health care before and during pregnancy. This, in line with the 2019 theme for World Prematurity Awareness Month, is key to supporting babies born too soon together with their families.

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