Born Too Soon: Care for the preterm baby
Identifieur interne : 002786 ( Ncbi/Merge ); précédent : 002785; suivant : 002787Born Too Soon: Care for the preterm baby
Auteurs : Joy E. Lawn [Royaume-Uni, Afrique du Sud] ; Ruth Davidge [Afrique du Sud] ; Vinod K. Paul [Inde] ; Severin Von Xylander [Suisse] ; Joseph De Graft Johnson [États-Unis] ; Anthony Costello [Royaume-Uni] ; Mary V. Kinney [Afrique du Sud] ; Joel Segre [États-Unis] ; Liz Molyneux [Malawi]Source :
- Reproductive Health [ 1742-4755 ] ; 2013.
Abstract
As part of a supplement entitled "Born Too Soon", this paper focuses on care of the preterm newborn. An estimated 15 million babies are born preterm, and the survival gap between those born in high and low income countries is widening, with one million deaths a year due to direct complications of preterm birth, and around one million more where preterm birth is a risk factor, especially amongst those who are also growth restricted. Most premature babies (>80%) are between 32 and 37 weeks of gestation, and many die needlessly for lack of simple care. We outline a series of packages of care that build on essential care for every newborn comprising support for immediate and exclusive breastfeeding, thermal care, and hygienic cord and skin care. For babies who do not breathe at birth, rapid neonatal resuscitation is crucial. Extra care for small babies, including Kangaroo Mother Care, and feeding support, can halve mortality in babies weighing <2000 g. Case management of newborns with signs of infection, safe oxygen management and supportive care for those with respiratory complications, and care for those with significant jaundice are all critical, and are especially dependent on competent nursing care. Neonatal intensive care units in high income settings are de-intensifying care, for example increasing use of continuous positive airway pressure (CPAP) and this makes comprehensive preterm care more transferable. For health systems in low and middle income settings with increasing facility births, district hospitals are the key frontier for improving obstetric and neonatal care, and some large scale programmes now include specific newborn care strategies. However there are still around 50 million births outside facilities, hence home visits for mothers and newborns, as well as women's groups are crucial for reaching these families, often the poorest. A fundamental challenge is improving programmatic tracking data for coverage and quality, and measuring disability-free survival. The power of parent's voices has been important in high-income countries in bringing attention to preterm newborns, but is still missing from the most affected countries.
This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal, Newborn and Child Health and the World Health Organization (WHO). The original article was published in PDF format in the WHO Report "Born Too Soon: the global action report on preterm birth" (ISBN 978 92 4 150343 30), which involved collaboration from more than 50 organizations. The article has been reformatted for journal publication and has undergone peer review according to
Url:
DOI: 10.1186/1742-4755-10-S1-S5
PubMed: 24625233
PubMed Central: 3828583
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<front><div type="abstract" xml:lang="en"><p>As part of a supplement entitled "Born Too Soon", this paper focuses on care of the preterm newborn. An estimated 15 million babies are born preterm, and the survival gap between those born in high and low income countries is widening, with one million deaths a year due to direct complications of preterm birth, and around one million more where preterm birth is a risk factor, especially amongst those who are also growth restricted. Most premature babies (>80%) are between 32 and 37 weeks of gestation, and many die needlessly for lack of simple care. We outline a series of packages of care that build on essential care for every newborn comprising support for immediate and exclusive breastfeeding, thermal care, and hygienic cord and skin care. For babies who do not breathe at birth, rapid neonatal resuscitation is crucial. Extra care for small babies, including Kangaroo Mother Care, and feeding support, can halve mortality in babies weighing <2000 g. Case management of newborns with signs of infection, safe oxygen management and supportive care for those with respiratory complications, and care for those with significant jaundice are all critical, and are especially dependent on competent nursing care. Neonatal intensive care units in high income settings are de-intensifying care, for example increasing use of continuous positive airway pressure (CPAP) and this makes comprehensive preterm care more transferable. For health systems in low and middle income settings with increasing facility births, district hospitals are the key frontier for improving obstetric and neonatal care, and some large scale programmes now include specific newborn care strategies. However there are still around 50 million births outside facilities, hence home visits for mothers and newborns, as well as women's groups are crucial for reaching these families, often the poorest. A fundamental challenge is improving programmatic tracking data for coverage and quality, and measuring disability-free survival. The power of parent's voices has been important in high-income countries in bringing attention to preterm newborns, but is still missing from the most affected countries.</p>
<sec><title>Declaration</title>
<p>This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal, Newborn and Child Health and the World Health Organization (WHO). The original article was published in PDF format in the WHO Report "Born Too Soon: the global action report on preterm birth" (ISBN 978 92 4 150343 30), which involved collaboration from more than 50 organizations. The article has been reformatted for journal publication and has undergone peer review according to <italic>Reproductive Health</italic>
's standard process for supplements and may feature some variations in content when compared to the original report. This co-publication makes the article available to the community in a full-text format.</p>
</sec>
</div>
</front>
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<pmc article-type="review-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Reprod Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Reprod Health</journal-id>
<journal-title-group><journal-title>Reproductive Health</journal-title>
</journal-title-group>
<issn pub-type="epub">1742-4755</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24625233</article-id>
<article-id pub-id-type="pmc">3828583</article-id>
<article-id pub-id-type="publisher-id">1742-4755-10-S1-S5</article-id>
<article-id pub-id-type="doi">10.1186/1742-4755-10-S1-S5</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>Born Too Soon: Care for the preterm baby</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Lawn</surname>
<given-names>Joy E</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<xref ref-type="aff" rid="I2">2</xref>
<email>joylawn@yahoo.co.uk</email>
</contrib>
<contrib contrib-type="author" id="A2"><name><surname>Davidge</surname>
<given-names>Ruth</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<xref ref-type="aff" rid="I4">4</xref>
<xref ref-type="aff" rid="I5">5</xref>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Paul</surname>
<given-names>Vinod K</given-names>
</name>
<xref ref-type="aff" rid="I6">6</xref>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>Xylander</surname>
<given-names>Severin von</given-names>
</name>
<xref ref-type="aff" rid="I7">7</xref>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>de Graft Johnson</surname>
<given-names>Joseph</given-names>
</name>
<xref ref-type="aff" rid="I8">8</xref>
</contrib>
<contrib contrib-type="author" id="A6"><name><surname>Costello</surname>
<given-names>Anthony</given-names>
</name>
<xref ref-type="aff" rid="I9">9</xref>
</contrib>
<contrib contrib-type="author" id="A7"><name><surname>Kinney</surname>
<given-names>Mary V</given-names>
</name>
<xref ref-type="aff" rid="I10">10</xref>
</contrib>
<contrib contrib-type="author" id="A8"><name><surname>Segre</surname>
<given-names>Joel</given-names>
</name>
<xref ref-type="aff" rid="I11">11</xref>
</contrib>
<contrib contrib-type="author" id="A9"><name><surname>Molyneux</surname>
<given-names>Liz</given-names>
</name>
<xref ref-type="aff" rid="I12">12</xref>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
MARCH, London School Hygiene & Tropical Medicine, UK</aff>
<aff id="I2"><label>2</label>
Saving Newborn Lives, Save the Children, Cape Town, South Africa</aff>
<aff id="I3"><label>3</label>
Kwa-Zulu Natal Dept. of Health, Pietermartizburg, South Africa</aff>
<aff id="I4"><label>4</label>
NNASA-Neonatal Nurses Association of Southern Africa, Durban, South Africa</aff>
<aff id="I5"><label>5</label>
Congress of International Neonatal Nurses (COINN</aff>
<aff id="I6"><label>6</label>
All India Institute for Medical Sciences, New Delhi, India</aff>
<aff id="I7"><label>7</label>
World Health Organization, Geneva, Switzerland</aff>
<aff id="I8"><label>8</label>
Save the Children and MCHIP, Washington DC, USA</aff>
<aff id="I9"><label>9</label>
University College London, UK</aff>
<aff id="I10"><label>10</label>
Saving Newborn Lives, Save the Children, Cape Town, South Africa</aff>
<aff id="I11"><label>11</label>
Consultant to Bill & Melinda Gates Foundation, Seattle, WA, USA</aff>
<aff id="I12"><label>12</label>
Queen Elizabeth Hospital, College of Medicine, Blantyre, Malawi</aff>
<pub-date pub-type="collection"><year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>15</day>
<month>11</month>
<year>2013</year>
</pub-date>
<volume>10</volume>
<issue>Suppl 1</issue>
<supplement><named-content content-type="supplement-title">Born too soon</named-content>
<named-content content-type="supplement-editor">Journal Editors: Jose Belizan and Pierre Buekens; series Editors: Christopher P Howson, Mary V Kinney and Joy E Lawn</named-content>
</supplement>
<fpage>S5</fpage>
<lpage>S5</lpage>
<permissions><copyright-statement>Copyright © 2013 Lawn et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>Lawn et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.reproductive-health-journal.com/content/10/S1/S5"></self-uri>
<abstract><p>As part of a supplement entitled "Born Too Soon", this paper focuses on care of the preterm newborn. An estimated 15 million babies are born preterm, and the survival gap between those born in high and low income countries is widening, with one million deaths a year due to direct complications of preterm birth, and around one million more where preterm birth is a risk factor, especially amongst those who are also growth restricted. Most premature babies (>80%) are between 32 and 37 weeks of gestation, and many die needlessly for lack of simple care. We outline a series of packages of care that build on essential care for every newborn comprising support for immediate and exclusive breastfeeding, thermal care, and hygienic cord and skin care. For babies who do not breathe at birth, rapid neonatal resuscitation is crucial. Extra care for small babies, including Kangaroo Mother Care, and feeding support, can halve mortality in babies weighing <2000 g. Case management of newborns with signs of infection, safe oxygen management and supportive care for those with respiratory complications, and care for those with significant jaundice are all critical, and are especially dependent on competent nursing care. Neonatal intensive care units in high income settings are de-intensifying care, for example increasing use of continuous positive airway pressure (CPAP) and this makes comprehensive preterm care more transferable. For health systems in low and middle income settings with increasing facility births, district hospitals are the key frontier for improving obstetric and neonatal care, and some large scale programmes now include specific newborn care strategies. However there are still around 50 million births outside facilities, hence home visits for mothers and newborns, as well as women's groups are crucial for reaching these families, often the poorest. A fundamental challenge is improving programmatic tracking data for coverage and quality, and measuring disability-free survival. The power of parent's voices has been important in high-income countries in bringing attention to preterm newborns, but is still missing from the most affected countries.</p>
<sec><title>Declaration</title>
<p>This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal, Newborn and Child Health and the World Health Organization (WHO). The original article was published in PDF format in the WHO Report "Born Too Soon: the global action report on preterm birth" (ISBN 978 92 4 150343 30), which involved collaboration from more than 50 organizations. The article has been reformatted for journal publication and has undergone peer review according to <italic>Reproductive Health</italic>
's standard process for supplements and may feature some variations in content when compared to the original report. This co-publication makes the article available to the community in a full-text format.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Inde</li>
<li>Malawi</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>États-Unis</li>
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<region><li>District de Columbia</li>
<li>Washington (État)</li>
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<name sortKey="Kinney, Mary V" sort="Kinney, Mary V" uniqKey="Kinney M" first="Mary V" last="Kinney">Mary V. Kinney</name>
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</noRegion>
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<country name="Suisse"><noRegion><name sortKey="Xylander, Severin Von" sort="Xylander, Severin Von" uniqKey="Xylander S" first="Severin Von" last="Xylander">Severin Von Xylander</name>
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<country name="États-Unis"><region name="District de Columbia"><name sortKey="De Graft Johnson, Joseph" sort="De Graft Johnson, Joseph" uniqKey="De Graft Johnson J" first="Joseph" last="De Graft Johnson">Joseph De Graft Johnson</name>
</region>
<name sortKey="Segre, Joel" sort="Segre, Joel" uniqKey="Segre J" first="Joel" last="Segre">Joel Segre</name>
</country>
<country name="Malawi"><noRegion><name sortKey="Molyneux, Liz" sort="Molyneux, Liz" uniqKey="Molyneux L" first="Liz" last="Molyneux">Liz Molyneux</name>
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</affiliations>
</record>
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