CHENNAI: Women breathe a sigh of relief after the pregnancy reaches the point at which the baby would be able to survive if born early, as prematurity is the major contributor to infant mortality in India. Paediatricians say that while one of the major issues related to increasing incidence is lack of awareness of the need of intervention for survival, facilities such as steroids, for lung development, mechanical ventilation and other invasive treatments at neonatal intensive care units (NICU) should be available.
Prematurity is the leading cause of infant deaths in Chennai. In a survey by Paediatrics Association, of 634 mothers who delivered preterm babies in Chennai, it was found that 423, i.e. 66 per cent had not expected this, or heard about prematurity and were ill-prepared to deal with the sudden crisis. 324 i.e. 51 per cent were not prepared for the financial stress of treating the baby in the NICU. Eleven per cent said they would have chosen hospitals that had a neonatal intensive care unit for delivery if they had been aware of the risk.
Therefore, lack of awareness of premature deliveries can give way to precautionary measures by mothers, thereby reducing the risk of premature deaths. “India tops the world in preterm deliveries with 21 percent incidence. At present 1 in 5 pregnancies can end in premature delivery. Premature births account for 50 per cent of neonatal mortality in India (deaths from 0 to 27 days of age) and are the leading cause of death in children less than 5 years of age (the second and third most common causes being pneumonia and complications during delivery),” said Dr Deepa Hariharan, senior paediatrician.
“The causes of prematurity include genetic risks, maternal infections, lifestyle diseases like diabetes, hypertension and stress, poor nutrition, advanced maternal age, short inter-pregnancy interval and multiple pregnancies. Catering to a healthy lifestyle can also avoid the risk of prematurity and premature infant deaths,” said Dr C. Satheesh, president, Indian Academy of Pediatrics. Prematurity causes substantial morbidity and can have long-term problems with hearing or vision, motor defects or learning disabilities and need early intervention and follow-up.
“Implementation of simple, cost-effective interventions like breastfeeding, infection control can help to reduce the risk of premature death by 75 per cent, 25 per cent need high technology intensive care for survival. This includes staying in NICU, ventilator care, medications, parental nutrition and intensive nursing. These steps can reduce the effects of disabilities on premature kids,” said Dr Mathrubootham Sridhar, consultant paediatrician, the Apollo Children’s Hospital.
Need awareness among parents: Expert
Indian Foundation for Premature Babies observed World Prematurity Day to sensitise on improving birth outcomes in India. Parents of around 40 babies born prematurely stood as healthy school-going kids, fighting against all odds and shared their story of struggle. Parents talked about preparedness to deal with prematurity and need to stay in neonatal ICU for a few weeks with ventilator support and blood transfusions.
Director Gautham Menon was the chief guest of the event, who also released the book based on premature babies titled, Miracle Babies. The research on preventing hospital-acquired pneumonia in babies which won international acclaim at the European Society for Pediatric Gastroenterology was also released. Dr Deepa Hariharan, senior pediatrician, stressed on the importance of awareness among people on prematurity, as is the major contributor to infant mortality in India.
“We need to lay emphasis on the need of awareness among parents to be prepared financially, mentally and adopt lifestyle changes to prevent prematurity. Adoption of newly developed technologies that can serve as treatment alternatives at hospitals and healthcare provider organizations is also significant to bring down death rates of premature babies.
