Simple solutions available to prevent stillbirths in developing nations


By AGENCY

No progress has been made in lowering the number of newborns being born either premature or underweight worldwide. — AFP

Providing simple and cheap healthcare measures to pregnant women, such as offering aspirin, could prevent more than a million babies from being stillborn or dying as newborns in developing countries every year, new research said on May 9 (2023).

An international team of researchers also estimated that one quarter of the world's babies are born either premature or underweight, adding that almost no progress is being made in this area.

The team called for governments and organisations to ramp up the care women and babies receive during pregnancy and birth in 81 low- and middle-income countries.

Eight proven and easily implementable measures could prevent more than 565,000 stillbirths in these countries, according to a series of papers published in the Lancet journal.

The measures included providing micronutrient, protein and energy supplements; low-dose aspirin; the hormone progesterone; education on the harms of smoking; and treatments for malaria, syphilis and bacteria in urine.

If steroids were made available to pregnant women and doctors did not immediately clamp the umbilical cord, the deaths of more than 475,000 newborn babies could also be prevented, the research found.

Implementing these changes would cost an estimated US$1.1 billion (RM4.92 billion), the researchers said.

This is "a fraction of what other health programmes receive", said lead study author and professor at Finland's Tampere University Per Ashorn.

Another study author, Joy Lawn of the London School for Hygiene and Tropical Medicine in the United Kingdom, said that the researchers used a new definition for babies born premature or underweight.

She said the traditional way to determine a baby had a low birthweight, i.e. if it was born weighing under 2.5 kilogrammes (5.8 pounds), was "a bit randomly selected" by a Finnish doctor in 1919.

This "very blunt measure" has remained the benchmark for more than a century, despite plentiful evidence that "those babies are not all the same", Lawn said.

The researchers analysed a database that included 160 million live births from 2000 to 2020 to work out how often babies are born "too soon and too small", she said.

"Quite shockingly, we found that this is much more common once you start to think about it in a more nuanced way."

The researchers estimated that 35.3 million – or one in four – of the babies born worldwide in 2020 were either premature or too small, classifying them under the new term "small vulnerable newborns".

While most of the babies were born in southern Asia and sub-Saharan Africa, Lawn emphasised that every country was affected.

Stopping bleeding after delivery

Another study published on May 9 (2023) estimated that a different simple and cheap treatment plan could reduce the rate of severe bleeding in women after giving birth by 60%.

Postpartum bleeding is the leading cause of women dying during pregnancy worldwide, affecting 14 million people a year, mostly in developing countries.

The treatment plan combines a drape, which is put under the woman to measure how much blood is being lost, with uterine massage, an intravenous drip and some drugs to stop the bleeding.

Study co-author Arri Coomarasamy of UK's Birmingham University said the new approach could "radically improve women's chances of surviving childbirth globally".

Pascale Allotey of the World Health Organization (WHO), which co-led the research, said: "No woman should fear for her life when giving birth."

The study, published in the New England Journal of Medicine, involved more than 210,000 women in Kenya, Nigeria, South Africa and Tanzania. – AFP Relaxnews

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