• Pre-Collegiate Global Health Review

Small but Mighty: Intersection Between Prematurity and Global Health

Aditi Bang and Rasagna Vuppala, South Forsyth High School, Cumming, Georgia, USA



Summary

Globally, over 15 million babies are born prematurely every year. Prematurity is the leading cause of neonatal mortality and does not only affect individuals in less developed countries.

Prematurity can be attributed to various causes such as poor maternal health, genetics, environmental exposures, and socioeconomic factors. Furthermore, in the United States, the economic burden associated with preterm birth and care was $32.4 billion in 2017, emphasizing how preterm birth is not only a physical issue but also a financial issue (CDC, 2018). In this article, we provide an elaborate discussion of the difficulties experienced by premature babies and their families. The rise in association between socioeconomic factors and preterm birth is global. Equity and equality within healthcare are pivotal to establishing healthy lives for premature babies. Various government systems have introduced public health interventions in order to promote healthy lives for the babies, their mothers, and their families. As community-oriented individuals, we hope to develop a positive impact on our society by bringing awareness about preterm birth and spreading the mission of Madhatter Knits Foundation, a nonprofit organization dedicated to providing beanies to premature babies.




Cries of joy erupt as the tension in the labor room settles into peace. Smiles cascade onto everyone’s faces as they see a young fetus become a neonate. Happiness permeates through the room as new life has been welcomed in to the world. Birth. A once in a lifetime experience inundated with satisfaction, happiness, and exhilaration. Most of us are fortunate to have undergone this moment and still experience the fruits of life; however, some struggle to sustain a fulfilling life: premature babies.


A premature baby is defined as one born before 37 weeks of gestation (CDC, 2020). A normal pregnancy lasts for about 280 days or 40 weeks which is why premature births are special cases that demand extra care and concern. Premature babies are monitored regularly with unstable bodily functions that need immediate, proper attention typically in Neonatal Intensive Care Units (NICUs). Generally, a premature baby misses out on the critical periods of gestation when the lungs, brain, and liver fully develop. Therefore, such babies are at higher risk for breathing problems, feeding difficulties, intellectual and developmental disabilities, and vision and hearing problems (CDC, 2020). There are additional medical complications that are associated with premature births. For example, premature babies are vulnerable to various conditions such as respiratory distress syndrome, apnea, and patent ductus arteriosus (CDC, 2020). Proper medical care of these babies is essential to mitigate adverse events.


Prematurity is a global issue, and many transnational commonalities in the potential causes (such as stress, poverty, and lack of healthcare) exist. Harmful substances such as alcohol and smoking can also lead to premature births. Proper prenatal care is essential to the wellbeing of the child and the mother in order to prevent premature births. The populations affected in the process include neonates and mothers who are both directly affected (physically and emotionally), and also families of the neonates who are indirectly affected (emotionally and financially).


In the last ten years, prematurity has been the leading cause of neonatal mortality, and now, it is becoming a prevalent cause of childhood mortality. One in ten infants born in the United States was born premature (The Impact of Premature Birth on Society, 2015). According to the WHO, more than 60% of preterm births take place in Africa and South Asia. In addition, prematurity is commonly seen in low-income areas; therefore, this not only affects second and third-world countries but rather is a global issue. Furthermore, preterm babies in low-income countries die about 90% of the time compared to 10% in high-income countries (WHO, n.d.). The environmental, societal, and economic drivers behind this disparity is an active field in global health research.


The lack of proper prenatal and maternal services factors into the growing rates of prematurity. Out of 15 million babies being born prematurely annually, 1 million die because of medical complications (WHO, n.d.). 75% of these deaths could have been prevented had affordable cost services been available. Proper prenatal services such as steroid injections, antibiotics, prenatal vitamins, and a healthy diet, would decrease the prematurity rate and provide comfort for both the mother and baby (Kids Health, 2018).


Various public health interventions have been enacted in order to prevent the exacerbation of prematurity. The PREEMIE Reauthorization Act was passed by the U.S. government to allow preterm birth research at the CDC and reauthorize programs that promote healthy pregnancies (March of Dimes, 2018). The goal of this act was to reduce the preterm birth rate in the United States. Programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Healthy Start, early intervention services, breastfeeding support, Home Visitation programs, Head Start, and literacy initiatives have been developed as a means of caring for women’s health before, during, and after pregnancy in order to prevent death and disability among newborns. Lastly, Perinatal Quality Collaboratives are working towards improving the quality of care for mothers and babies. Specifically, they promote the use of certain steroids to prevent morbidity and certain medications to prevent preterm birth in high risk women (CDC, 2017).


Interventions are crucial to the limitation of prematurity across the world. As co-founders of GA Madhatter Knits Foundation, a nonprofit organization that supplies knit hats to NICUs, we both carry a special connection to this topic as we strive to help these babies and their families by providing them with love and care. Not only do we teach our volunteers how to knit, but we also provide resources for our community to understand prematurity and actions they can take to limit it further. Currently, we have expanded to over 50 volunteers and donated to six NICUs with over 10 shipments to Georgia; we have knitted over 1,000 hats for premature babies. Our goal is to spread awareness about prematurity to our community regarding the risks of alcohol, smoking, drugs, and unhealthy diets for preterm labor; we hope to help our peers understand the significance of this issue, and show them a path to make a difference too.

Figure 1. The beanies [Bang and Vuppala] donated to premature babies in NICU’s across Georgia

References


Centers for Disease Control and Prevention. (2017, August 17). CDC Grand Rounds: cake Public Health Strategies to Prevent Preterm Birth. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm


Centers for Disease Control and Prevention. (2020, October 30). CDC Preterm Birth cake Activities. Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermcdc-activities.html.


Centers for Disease Control and Prevention. (2020, October 30). Preterm Birth. Centers cake for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm.


Fuentes, A. (Ed.). (2018, October). Treatments to prevent premature birth (for parents) - cake nemours kidshealth. KidsHealth.

https://kidshealth.org/en/parents/treatments-prevent-premature-birth.html


PREEMIE Act 2018. Home. (n.d.).

https://www.marchofdimes.org/advocacy/preemie-act-2018.aspx#:~:text=Background,preterm%20birth%20and%20its%20consequences.&text=From%202006%20until%202014%2C%20the,an%20historic%20low%20in%202014


The impact of premature birth on society. (2015, October). Copyright 2021 March of cake Dimes Foundation. All Rights Reserved.

https://www.marchofdimes.org/mission/the-economic-and-societal-costs.aspx#


World Health Organization. (n.d.). Preterm birth. World Health Organization.

https://www.who.int/news-room/fact-sheets/detail/preterm-birth

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