Study shows heightened risks for premature babies in Bangladesh

A recently published study in Bangladesh titled Clinical outcome of the late preterm infants shows that premature babies can develop major neonatal complications that need admission in a neonatal intensive care unit.

The study has found that late preterm or premature babies born before 37 weeks instead of the normal 40 weeks, have higher risks of developing health complications like jaundice, sepsis (a life-threatening infection) and respiratory problems than normal or term babies.

It is important to understand these risks and how to reduce them because experts estimate that 48 percent of newborn deaths in Bangladesh are due to complications from premature birth (UNFPA, UNICEF).

The retrospective study evaluated the short-term clinical outcome of late pre-term babies (born at 34-36 weeks) in a tertiary hospital from January 2013 to December 2014. A total of 3,749 babies were delivered during this period of which 513 were late pre-term. Admission to the neonatal intensive care unit after birth was needed in the case of 66 (12.9 percent) late pre-term babies and 36 (1.1 percent) term babies.

Of the babies admitted to neonatal intensive care, 11 of the pre-term babies required ventilation, compared with just two of the full-term babies. Seven of the pre-term babies died, whereas all of the full-term babies were discharged from the unit.

The study also found higher incidences of complications like jaundice (14.4 percent), sepsis (6.2 percent), respiratory distress syndrome (2.9 percent) and transient tachypnea (abnormally rapid beating of the respiratory, 2.3 percent) in comparison to term or fully grown babies born between 37 and 40 weeks.

"In the study, the rate of critical care admission and the need for respiratory support in late preterm infants were high in comparison to term infants," observes Dr. Lutfun Nahar Begum, the lead author of the study published in the Journal of Bangabandhu Sheikh Mujib Medical University. "Respiratory morbidity is nearly 14-fold higher in late preterm when compared with term infants. In the study, respiratory distress syndrome was seen in 15 late preterm babies compared to only one in term baby."

She explains: "One of the main reasons for deaths of preterm babies in Bangladesh is lack of nutrition in mothers, which is why we have very high incidence of low birth weight babies among the premature babies."

"There is awareness but I still believe that lack of knowledge of optimal diet and quality care and multiple pregnancies are responsible for such high incidence of deaths of premature babies," she adds.

In addition, she notes limitations in facilities: "Unlike in developed countries, tertiary hospitals in many cities in Bangladesh lack minimum life support facilities like mechanical ventilators, incubators, blood pressure monitor, pulse oximeter, continuous positive airway pressure (CPAP) and x-ray machines."