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More than 15 million of the babies born around the world each year come too soon, with tremendous cost in lives lost and disabled -- and medical expense.
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Yet newly-published research shows many early infants, even in developed nations like the U.S., could benefit from wider use of some simple caregiving methods.
Research published last week found that of 15.1 million preemies (born at less than 37 weeks' gestation in 2012), 13 million survived beyond the first week of life and the deaths of one million were due to complications of prematurity. More than a million who survived faced some degree of disability. The research was published in a group of papers in the journal Pediatric Research.
In the United States, 450,000 babies were born early, nearly one out of nine births -- numbers in line with countries like the Congo and Bangladesh -- and the most of any industrialized country. And that's an improvement. The preterm birth rate in 2012 was 11.5 percent, down from 12.5 percent in 2006.
More than 80 percent of babies born earlier than 37 weeks in wealthy nations survive, often after long stays in intensive care, but many are likely to have long-term physical and intellectual disabilities; in low-income nations, death is twice as likely as disability among preterm infants.
The Institute of Medicine has estimated that preterm birth in the U.S. costs more than $26 billion a year. Early babies often face health problems ranging from breathing difficulties, jaundice and vision loss to cerebral palsy and developmental delays.
Dr. Joy Lawn, a neonatologist and epidemiologist at the London School of Hygiene and Tropical Medicine and leader of the research team, said most newborn deaths could be prevented without intensive care.
"Some inexpensive methods that have shown very good improvement are not being used in many countries with a high pre-term burden. Whether babies are born in the U.S. or Ethiopia, they should all get the same good care,'' Lawn said in a phone interview.
For instance, two injections of a steroid used to treat asthma, given to mothers in preterm labor, can speed along development of a baby's lungs and reduce the risk of breathing distress when they're born. The treatment costs about $1.
Or keeping preemies warm and with skin-to-skin contact to mom's chest -- a technique called Kangaroo Mother Care -- helps reduce the risk of illness and fosters breastfeeding. "This works as well in a neonatal care unit as it does in the developing world, but not many hospitals in nations like the U.S. will promote it,'' Lawn said.
The researchers estimate as many as 75 percent of preterm babies who die would survive if the two interventions were commonly used.
The research also showed that worldwide, boys are about 14 percent more likely to be born preterm than girls, in large part because women pregnant with boys are more likely to have placental problems, high blood pressure and high protein levels in their urine that are associated with early birth.
Lawn said more research is needed to understand all the causes of early birth, but "we also need to make better use of what we already know."