10-04-2017, 09:33 PM
preterm baby seminar
UCSF Benioff Children's Hospitals today announced a $100 million global initiative to address the epidemic of premature birth, the leading cause of death for newborns and the second leading cause of death for children under five. The 10-year, global initiative will be jointly funded by Lynne and Marc Benioff in partnership with the Bill & Melinda Gates Foundation.
Approximately 15 million babies are born premature each year, and more than one million of these infants die within the first 28 days after birth due to complications of prematurity. UCSF Benioff Children's Hospitals will lead a collaborative global effort aimed at reducing the number of children born premature, and protecting the health of preterm babies and women around the world.
Working together with scientists in other regions of the world, the initiative will focus on the biological, behavioral and social factors that drive prematurity defined as being born before 37 weeks and how to protect children from its consequences. They will explore the barriers at the family, community and society level that prevent good practices from being widely adopted, and they will contribute to the development of new drugs, diagnostic tools and medical devices.
Jaime Sepulveda, MD, MPH, MSc, DrSc, executive director of UCSF Global Health Sciences will co-direct the Initiative with Larry Rand, MD, director of Perinatal Services at the UCSF Benioff Children's Hospital San Francisco Fetal Treatment Center and the Principal Investigator of the Preterm Birth Initiative.
"Premature birth is one area in global health where little progress has been made," said Sepulveda. "We will work with local communities and global partners to translate science into solutions that make a measurable impact on the health of babies and mothers."
"We want to move away from the model of isolated impact, in which one organization tries to do all the work or make all the discoveries," said Rand, who holds the Lynne and Marc Benioff Endowed Chair in Maternal Fetal Medicine at UCSF Benioff Children's Hospital San Francisco. "To be successful, this has to be a team effort. Effective collaboration will accelerate discovery, increase access to interventions that work and optimize the project's impact on rates of early preterm birth and mortality."
Preterm birth, also known as premature birth, is the birth of a baby at less than 37 weeks gestational age.These babies are known as preemies or premmies. Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes or the leaking of fluid from the vagina. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems, and problems seeing. These risks are greater the earlier a baby is born.
The cause of preterm birth is often not known. Risk factors include diabetes, high blood pressure, being pregnant with more than one baby, being either obese or underweight, a number of vaginal infections, tobacco smoking, and psychological stress, among others. It is recommended that labor not be medically induced before 39 weeks unless required for other medical reasons. The same recommendation applies to cesarean section. Medical reasons for early delivery include preeclampsia.
In those at risk, the hormone progesterone, if taken during pregnancy, may prevent preterm birth. Evidence does not support the usefulness of bed rest. It is estimated that at least 75% of preterm infants would survive with appropriate treatment. In women who might deliver between 24 and 34 weeks corticosteroids improve outcomes.A number of medications including nifedipine may delay delivery so that a mother can be moved to where more medical care is available and the corticosteroids have a greater chance to work. Once the baby is born care includes keeping the baby warm through skin to skin contact, supporting breastfeeding, treating infections, and supporting breathing.
Preterm birth is the most common cause of death among infants worldwide. About 15 million babies are preterm each year (5% to 18% of all deliveries). In many countries rates of premature births have increased between the 1990s and 2010s. Complications from preterm births resulted in 0.74 million deaths in 2013 down from 1.57 million in 1990. The chance of survival at less than 23 weeks is close to zero, while at 23 weeks it is 15%, 24 weeks 55% and 25 weeks about 80%. The chances of survival without long term difficulties is less.