Neonatologists want high-risk pregnancies identified early to avoid preterm births

On World Premature Day observed on Thursday, neonatologists are looking at finding ways to reduce the number of preterm births.

In the State, 20% of the 9.7 lakh deliveries annually are premature. Though the statistics match world figures the reasons for prematurity are a cause for concern, said S. Srinivasan, State nodal officer, Child Health, Institute of Child Health. “The worry is early preterm babies, those born before 34 weeks of gestation,” he said. With the Supreme Court permitting delivery of 22-week-old neonates, the challenge is to ensure infants weighing 400 gm to 500 gm survive.”

Around 2,000 babies born in the State are below 1kg in weight and 40% of them survive. The survival rate climbs to 75% among infants weighing 1-1.5kg, he explained. Premature birth could be due to the mother’s health, multiple foetuses and infertility treatment. The challenge is to identify high-risk pregnancies and reduce prematurity, he added.

Rahul Yadav, lead consultant, paediatrics and neonatology at Rainbow Children’s Hospital concurred with him. “In our hospital we were pleasantly surprised to find that 24-26 week olds and even 22-24 week old babies have done well. Our outcomes in India are better than that in western countries. We should make Japan and Scandinavian countries our role models,” he said. The cause of prematurity was more important than a baby’s gestational age, however.

“Sometimes preterm babies born at a later stage could die but younger ones will survive. We also found that we could give good results for babies born outside the hospital. These insights were new for us,” he said.

Deepa Hariharan, consultant neonatologist at Sooriya hospital also said the concern was about babies born in the 34th, 35th week. Since they appear normal there is a delay in bringing them to the hospital but by then the damage is done. An ante-natal mother when counselled repeatedly on tending to a preterm baby does better, she said. The theme for this year is encouraging parents to embrace their newborn soon after birth. Such immediate skin contact improves the baby’s breathing and lung function.

“Skin to skin contact should start in the delivery room and it is important in the first hour itself. Early skin-to-skin contact happens better only when there has been counselling of the ante-natal mother. Lack of trained personnel rather than safety concern for the baby leads to delay. We have made a lot of advances in treating micro premies but it is the older babies that are a matter of concern,” she added.