The latest WHO data
On 17 November, it was declared worldwide 'World Premature Child Day' with the specific aim of raising global public and government awareness of the problems associated with prematurity and the steps that could be taken to prevent it.
Premature babies are those born before the age of 37.but week of pregnancy. According to updated data from the WHO (World Health Organisation), around 15 million babies are born preterm in the world every year, 1 in 10, and an estimated 40,000 in Italy alone.
Approximately 1 million of these children die from complications due to prematurity, while many of those who manage to survive are destined to develop severe deficits, including ROP, the Retinopathy of the Prematurea severe ischaemic-vascular-proliferative disease affecting the retina of preterm infants.
According to the latest WHO data, the highest rates of prematurity are currently in India, China, Nigeria, Pakistan and Indonesia. In developed countries, almost all preterm births manage to survive, and in the last 10-15 years ROP cases have also been declining in middle-income countries such as Latin America, Eastern Europe and emerging South-East Asian countries (including Vietnam), while they remain high in China and India.
Among the factors that have favoured the reduction of ROP cases in developed countries, mention must be made of measures to carefully monitor the use of oxygen in incubators. Indeed, while in the case of premature births hypoxia is a condition to be avoided, prolonged hyperoxia (i.e. an excess of oxygen) can cause oxidative stress and significant damage to developing tissues. Repeated episodes of alternating hyperoxia and hypoxia can lead to significant alterations in vascular tone by inducing the production of angiogenetic factors in abnormal quantities.
But what can be done to prevent preterm birth and its complications?
So much can be done in developing countries, as it is estimated that about three quarters of premature infants could be saved through 'cost-effective' treatments, such as proper management of delivery and the early postnatal period.
However, in both developed and developing countries, prevention of premature mortality and complications should start with ensuring optimal health conditions during pregnancy.
The WHO has developed guidelines for the gestation period, which include some basic rules:
- Adopt a healthy diet that ensures an optimal and balanced nutritional intake. The mother's diet affects the health and development of the foetus.
- Absolutely avoid cigarette smoking and the use of chemicals.
- Use imaging to monitor regular fetal growth, determine gestational age and detect multiple pregnancies early.
A final note concerns the age of the mother-to-be: pregnancies under 18 and over 40 should be avoided. Indeed, in countries where premature birth rates are on the rise, possible causes include: 1) the increased age of mothers and associated health problems such as diabetes and hypertension; 2) increased use of infertility treatments, which are accompanied by increased rates of multiple pregnancies; and 3) changes in obstetrical practices, such as increased use of caesarean sections before the physiological term of pregnancy is completed.
WHO sources http://www.who.int/mediacentre/factsheets/fs363/en/
Dr. Carmelo Chines
Direttore responsabile
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