Premature baby sleeps in the neonatal ICU.Credit: Jill Lehmann Photography/ Moment/ Getty Images
Complications of a preterm birth remain the leading cause of mortality in babies and children under five years old, accounting for approximately one million deaths in 2021.The Preterm Birth Committee of the International Federation of Gynaecology and Obstetrics highlighted five key interventions in a study published in the International Journal of Gynecology and Obstetrics.
“Preterm labour is difficult to prevent, particularly in low-resourced areas, but deaths can be significantly reduced and outcomes improved by simple measures at the time of delivery,” said Andrew Shennan, a professor in the Department of Women and Children’s Health at King's College in London and co-author of the study.
The authors advised a course of antenatal corticosteroids before delivery to boost lung development and in turn improve breathing.
They also recommended giving the mother magnesium sulphate right before delivery to stabilise cell membranes and protect against brain damage.
After birth, the authors say that delaying cord clamping for at least a minute decreases the requirement for vasoactive drugs and for transfusion.
Early feeding with breastmilk within an hour of delivery has an array of benefits, including reducing feeding intolerance, improving neurological outcomes, and improving mother-infant bonding.
The committee also made these interventions available in a video to distribute to healthcare providers.
These measures are cost effective and easy to implement but can have a significant impact in low and middle-income countries, where approximately 80% of preterm births occur, explains Cathy Cluver, professor in the Department of Obstetrics and Gynaecology in Stellenbosch University in South Africa.
“ This compounds significant global disparities in neonatal outcomes: In high-income countries, up to nine in 10 infants born before 28 weeks survive, with this number falling to one in 10 in low-income countries," says Cluver.
