Saving premature babies requires evidence-based practices


It created a tragic episode in the life of Mim as she had to bear the unbearable burden of losing her three-day old baby. The premature birth of the baby led to her death, creating a lifelong pathos for Mim, who was married to Raiyan two years ago, reports BSS.

After two years of their wedding, they planned to have a baby, and Mim conceived accordingly. After conceiving only six months and 23 days, she (Mim) gave birth to a premature baby who died after three days of her birth. The tragic death of Mim’s baby was no exception as premature birth is a significant public health concern in Bangladesh.

Preterm birth is the world’s number one cause of new-born deaths. As more babies die from complications of prematurity than many other countries, saving premature babies is a daunting task for healthcare professionals. Ninety-nine percent of these deaths occur in middle and low income families.

Health experts have identified preterm birth complications as the number one cause for the high death rate of newborns in Bangladesh. Many of the premature babies who survive suffer from various disabilities like cerebral palsy, sensory deficits, learning disabilities and respiratory illness, physicians said.

The rate of preterm birth, which is associated with some risk factors including adolescence pregnancy, short spacing between pregnancies, hypertension and obesity, is very high in the country, they said. Directorate General of Health Services (DGHS) sources said more than 3 million children are born every year in Bangladesh. The death from premature birth now tops the list.

Sources said out of 3 million children, some 0.6 million are born premature, and out of that 0.6 million premature births 20,000 infants die. Dr Shamim Jahan, Director of Health, Nutrition & HIVAIDS, Save the Children, said the number has decreased in comparison to 2016 as 23620 infants died due to premature birth that year.

Dr Monir Hossain of Dhaka Shishu Hospital said Bangladesh ranks seven among top ten countries of the World in terms of premature birth. “If a child is born before 37 weeks of pregnancy, it is considered as premature,” he added. He said, “We found that prematurity is number one cause of under-five mortality. According to WHO, 14 percent of the children born in the country is premature, which means one premature birth out of seven.”

The number of extreme premature, born before 28 weeks, has been estimated at 22,000 a year, Dr Monir said, adding these babies are considered as extreme pre-term and need extensive healthcare support.

The rate of prematurity can be lowered by bringing changes in lifestyle, ensuring infection prevention and early treatment of infection by paying attention to proper nutrition, preventing malnutrition and ensuring management in timing and spacing between pregnancies, he added. The doctor said, “We do not know the actual reason behind the premature birth of a child. But we know that there are some risk factors responsible for premature birth.”

These are adolescent pregnancy, short intervals between pregnancies, hypertension, obesity, sexually transmitted infectious disease, history of prematurity, tobacco use and pollution, especially caused by cooking inside the living area, Dr Monir added.

Neonatologist Dr Saidur Rahman Shohag said, “Kangaroo Mother Care (KMC) is a life-saving intervention for preterm babies that costs almost nothing. We can expand KMC intervention through motivation and behavioral change to prevent preterm deaths.”

To offer premature babies the best chance of survival, evidence-based practices should be turned into action to provide optimal care during pregnancy. Health experts said there is a need to create health facilities for birthing and caring for sick neonates. Strengthening services at medical colleges and creating special care neonatal units at district and upazila levels should also be ensured, they added.

Round-the-clock availability of skilled staff should be mandatory in facilities caring for preterm or sick neonates.