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Born Too Soon: Care for the preterm baby

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 complicat...

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Autores principales: Lawn, Joy E, Davidge, Ruth, Paul, Vinod K, Xylander, Severin von, de Graft Johnson, Joseph, Costello, Anthony, Kinney, Mary V, Segre, Joel, Molyneux, Liz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828583/
https://www.ncbi.nlm.nih.gov/pubmed/24625233
http://dx.doi.org/10.1186/1742-4755-10-S1-S5
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author Lawn, Joy E
Davidge, Ruth
Paul, Vinod K
Xylander, Severin von
de Graft Johnson, Joseph
Costello, Anthony
Kinney, Mary V
Segre, Joel
Molyneux, Liz
author_facet Lawn, Joy E
Davidge, Ruth
Paul, Vinod K
Xylander, Severin von
de Graft Johnson, Joseph
Costello, Anthony
Kinney, Mary V
Segre, Joel
Molyneux, Liz
author_sort Lawn, Joy E
collection PubMed
description 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. DECLARATION: 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 Reproductive Health'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.
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spelling pubmed-38285832013-11-20 Born Too Soon: Care for the preterm baby Lawn, Joy E Davidge, Ruth Paul, Vinod K Xylander, Severin von de Graft Johnson, Joseph Costello, Anthony Kinney, Mary V Segre, Joel Molyneux, Liz Reprod Health Review 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. DECLARATION: 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 Reproductive Health'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. BioMed Central 2013-11-15 /pmc/articles/PMC3828583/ /pubmed/24625233 http://dx.doi.org/10.1186/1742-4755-10-S1-S5 Text en Copyright © 2013 Lawn et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Lawn, Joy E
Davidge, Ruth
Paul, Vinod K
Xylander, Severin von
de Graft Johnson, Joseph
Costello, Anthony
Kinney, Mary V
Segre, Joel
Molyneux, Liz
Born Too Soon: Care for the preterm baby
title Born Too Soon: Care for the preterm baby
title_full Born Too Soon: Care for the preterm baby
title_fullStr Born Too Soon: Care for the preterm baby
title_full_unstemmed Born Too Soon: Care for the preterm baby
title_short Born Too Soon: Care for the preterm baby
title_sort born too soon: care for the preterm baby
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828583/
https://www.ncbi.nlm.nih.gov/pubmed/24625233
http://dx.doi.org/10.1186/1742-4755-10-S1-S5
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