Premature births rising in India, states lack neonatal care centres: report
Around 300,000 pre-terms die annually in India due to complications, says report
New Delhi: The rate of premature births in India is rising and is presently around 21% of babies, according to a report released on Saturday.
The rate of pre-term birth ranges from 5-18% of babies born across 184 countries, according to WHO.
The report, Delivered Too Soon, was prepared by the Indian Foundation for Premature Babies (IFPB), a grouping of doctors across India.
Globally, prematurity is the leading cause of newborn deaths and the second leading cause of death after pneumonia in children under the age of five.
India is the biggest contributor to the world’s prematurity burden, with almost 3.6 million premature births—accounting for 23.6% of the around 15 million global pre-term births—reported each year. Of these, 13% are live pre-term births.
Premature births refer to births that take place before 36 weeks of the gestation period.
“The paradigm of premature deliveries in India is changing and has become a disease of the marginalized as well at the affluent. Around 300,000 pre-terms annually die due to complications in India. The most important intervention in this regard is birth spacing and treatment of maternal infections. Thus, creating the highest level of awareness on this issue is critical,” said Dr. Lata Bhat of IFPB.
The report also raises concerns about the financial burden on families to save a premature infant; the maximum burden is seen when the baby is between 28 to 36 weeks.
The report included the factors resulting in premature births such as young or advanced maternal age, low maternal body mass index, short inter-pregnancy intervals, pre-existing non-communicable disease and increasing psychological stress.
The study highlighted that stress among Indian working women and their lack of rest during pregnancies is one of the leading factors for pre-term births.
In high income settings, half of the babies born at 24 weeks are likely to survive, but in low-income settings half of the babies born even at 32 weeks die due to a lack of basic care, the report said.
If born before 28 weeks, the babies need neonatal intensive care services to survive, and most babies born between 28 and 32 weeks require special newborn care.
The incidence of late pre-term is also rising in India. Late pre-term refers to infants born between 34 and 36 weeks of gestation. States such as Goa , Kerala and Manipur have infant and neonatal mortalities similar to that of developed nations, indicating advanced care of premature babies.
The report said three-quarters of premature babies could be saved with current, cost-effective interventions, even without the availability of neonatal intensive care facilities.
Measures such as antenatal steroid injections, kangaroo mother care, antiseptic cream for the umbilical cord, and antibiotics to treat newborn infections were some of the measures mentioned.
According to the report, while states like Karnataka, Maharashtra and Kerala had the most number of rehabilitation centres for high risk children, high population states like Uttar Pradesh and Madhya Pradesh had less than 10.
“We are aware of the growing challenges associated with pre-term births in India. The ministry of health and family welfare is working towards a multi-pronged strategy to prevent pre term births,” said Syeda Hameed, member, Planning Commission.