NOVEMBER was originally designated as Prematurity Awareness Month by March of Dimes in the US in 2003, in an attempt to spread awareness about the burden of prematurity and drive a reduction in mortality. This year will mark the 20th year in existence of this initiative which has become internationally recognised.
A premature infant is defined as a baby born before 37 completed weeks of pregnancy. One in 10 newborns are delivered prematurely for a variety of reasons, including maternal, foetal, and at times unknown causes. In 2020, 13.4 million babies were born preterm globally and accounted for one million newborn deaths in 2021 (Born too soon: a decade of action on preterm birth 2023).
Prematurity is associated with many complications related to underdevelopment of the baby's organs. These babies are often critically ill and require neonatal intensive care admission and extensive support. Complications include but are not limited to problems with breathing and with the gastrointestinal tract; blindness; brain injury resulting in cerebral palsy; intellectual, learning and behavioural challenges.
Despite advances in medicine, the incidence of prematurity has not changed over the years, and the associated morbidity and mortality rate continues to be a financial, emotional, mental and social burden to families and the health-care system. Additionally, inequity in health-care resources between resource-limited and developed countries creates an unacceptably large survival gap for babies born preterm. Preterm birth rates were 9.9 per cent in 2020 vs 9.8 per cent in 2010. Notably, there has been little change in the preterm birth-related burden in the most heavily impacted areas of the globe.
In Jamaica, according to PAHO, the incidence of low birth weight in Jamaica in 2023 was 11.6 per cent. Despite these challenges, there have been considerable advances in the care of newborn infants, and infants at much younger gestational ages are surviving - however, much of this progress has been in high-resource countries.
The most recent Born Too Soon report has set an ambitious mandate to reduce the burden of preterm birth, with recommendations for a holistic approach. Caring for Miracles Foundation, in an attempt to align with these recommendations, adopts neonatal intensive care units in low- and middle-income countries, and partners with local government and other organisations to build capacity through support for the purchase of equipment, education of health-care staff, and by nurturing resilience in the health-care teams and the families that they serve.
The foundation's first adoptee is the Neonatal Intensive Care Unit at the University Hospital of the West Indies. This year the foundation has partnered with European Foundation for the Care of Newborn Infants (EFCNI) and other international organisations to spread awareness about the burdens and challenges of prematurity as well as the stories of miracles that occur daily.
In recognition of World Prematurity Day on November 17 the foundation hosted an information booth at Churchill Square, UHWI, where attendees got an opportunity to interface with health-care workers and parents of preterm infants, as well as some of the actual miracles. In addition, the third annual virtual Caring for Babies Born Too Soon Symposium will be held on November 25, 2023 under the theme: 'Protect the brain; change the trajectory. What's new in neuroprotection for the preterm neonate?'
This symposium, which will feature a multidisciplinary panel of international speakers and the perspective of parents of former premature infants, seeks to provide attendees with up to date evidence on approaches to protecting the vulnerable brains of these infants. It has become increasingly clear that even routine care practices may have a long-term impact on brain development and outcomes, and evidenced-based measures to mitigate this will be discussed.
The symposium targets all health-care providers involved in perinatal and neonatal care, including obstetricians, neonatologists, paediatricians and paediatric residents, neonatal and paediatric nurses and midwives, radiologists, anaesthetists, the allied health team, medical and nursing students. All parents and families of preterm infants, and any interested community partners are welcomed. Attendees will hear from the parents of premature infants and interface with the expert panel.
You may register by clicking on the link: https://www.caringformiracles.com/
This article was prepared by Dr Jillian M Lewis, consultant neonatologist, University Hospital of the West Indies; associate lecturer, University of the West Indies; and founder/chair Board of Directors, The Caring for Miracles Foundation.