Care of Preterm Birth

Babies born before 37 completed weeks of gestation are preterm, which totals about 10% of all births.[i] Preterm birth (PTB) and resulting complications are the leading causes of newborn deaths, leading to more than one million deaths per year. Preterm babies have difficulties feeding and maintaining body temperature. A three-phased approach to PTB is illustrated in Figure 1.[ii]

Figure 1. Three-phased approach to preterm birth

 

Kangaroo Mother Care

Kangaroo mother care (KMC) helps a newborn maintain body temperature by promoting continuous skin-to-skin contact and feeding exclusively with human milk. It promotes early discharge with close follow-up for preterm and LBW babies. Although KMC was conceived as a facility-based strategy for low-resource settings (in Bogota, Colombia), evidence shows an approximately 50% reduction in newborn mortality, and the method is used even in high-technology settings for better outcomes and humanization of neonatal care. Current evidence is insufficient for KMC initiated in the community.[i]

Antenatal Corticosteroids

Administration of antenatal corticosteroids (ACS) is the single most beneficial intervention for newborns born prematurely. ACS reduces respiratory distress syndrome and other preterm morbidities, and ultimately, death by more than 30%. ACS is a facility-based intervention but NGOs can intervene in a few ways: Refer women at risk of PTB to a higher level facility for care; advocate for national protocols for the use of ACS in PTB management; ensure a functioning supply and delivery system for medication and supplies; ensure ANC includes information about conditions that predispose a woman for PTB-like preterm uterine contractions, preterm rupture of membranes, and symptoms of PE-E; increase community awareness of PTB prevention and signs of threatened PTB; and support provision of essential newborn care with appropriate services like KMC for premature babies.[ii]

Key Resources for Care of Preterm Birth:


[i] Sloan, N., et al. Community-Based Kangaroo Mother Care to Prevent Neonatal and Infant Mortality: A Randomized, Controlled Cluster Trial. Pediatrics 2008; 121:e1047.

[ii] MCHIP, 2013. Administration of antenatal corticosteroids. https://www.mchip.net/sites/default/files/ACS%20Technical%20Briefer.pdf

[i] MCHIP, 2013. Administration of antenatal corticosteroids. https://www.mchip.net/sites/default/files/ACS%20Technical%20Briefer.pdf

[ii] Ibid.