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World Prematurity Day is observed on 17 November each year to raise awareness of preterm births and the concerns of preterm babies and their families worldwide. Approximately 15 million babies are born preterm each year, accounting for about one in 10 of all babies worldwide. About 84,000 of these births occur in South Africa, and 10% of the preterm infants born in South Africa do not survive despite that the majority of preterm births occurs at healthcare facilities. In South Africa, more than eight out of 100 babies are premature (before 37 weeks of pregnancy) and we rank 24th out of 184 countries for the number of newborn deaths due to complications from preterm birth.

Prematurity is one of the major causes of neonatal death

Prematurity is one of the major causes of neonatal death. South Africa as a signatory to the United Nations has committed to the Sustainable Development Goals to which all countries aiming to reduce neonatal mortality to at least as low as 12 deaths per 1,000 live births. South Africa has made some progress towards reducing the neonatal mortality rate but worrisomely, prematurity rates have not improved. The number of preterm births in South Africa has increased, with one in seven babies born premature – that is 15% of all births in the country

While prematurity carries a higher risk for mortality, the short- and long-term morbidity and health complications have costly implications for families. These include but are not limited to respiratory distress syndrome, necrotising enterocolitis, bronchopulmonary dysplasia, intraventricular haemorrhage, sepsis, feeding difficulties, and auditory and visual difficulties. And a spectrum of neurodevelopment conditions. The most effective interventions to decrease premature births are improved antenatal care practices, maternal health and neonatal care.  These interventions are priority areas for the first 1,000 days to improve child health and development.

Tips for women

Women are encouraged to attend antenatal care services as soon as they become aware they are pregnant. Pregnant women are encouraged to comply with the recommended minimum of four visits for antenatal care during the duration of their pregnancy, to take their medication and iron-folate supplements as recommended and to maintain a healthy weight during pregnancy.  Pregnant women are strongly discouraged from using alcohol, drugs and smoking during pregnancy. These all have a negative impact on the developing baby and the child’s long-term health and development.

For premature babies, a number of cost-effective, life-saving interventions such as Kangaroo Mother Care – keeping babies in skin-to-skin contact with the caregiver helps baby to conserve heat energy and build immunity. The promotion and support of exclusive breastfeeding by using expressed breastmilk and supporting babies to feed at the breast are proven to be life-saving interventions. To improve the lives of children in South Africa, it is imperative to reduce the number of premature births if children are to grow and realise their full potential.

Opinion article by Dr Chantell Witten, Division of Health Professions Education, University of the Free State.