Many newborn deaths are easily preventable - Study finds

Study: Millions of Newborns Die Needlessly
Joe DeCapua
August 30, 2011
VOA

Each year, millions of babies die within the first few weeks of life. A new report from the World Health Organization and Save the Children says many of those newborn deaths are easily preventable.

“This is the most comprehensive picture that we have to date of what’s happening for newborn deaths around the world and over time. And these estimates look at 193 countries and over 20 years,” said Dr. Joy Lawn of Save the Children, co-author of the study.

She said newborns are “barely on the global health agenda.”

So young, so vulnerable

“Every year, in the first month of life, there are 3.3 million babies who die. This is a huge number of deaths. It sounds overwhelming, but each of those deaths is a mother who has lost a baby, a family who has lost an expected life. And so we shouldn’t let the numbers overwhelm each individual tragedy that’s behind those,” she said.

Newborn deaths make up over 40 percent of child deaths worldwide.

India has the highest number of newborn deaths each year – more than 900,000. India, along with Nigeria, Pakistan, China and the Democratic Republic of Congo, accounts for more than half of the 3.3 million deaths.

Slow progress

“In certain areas,” said Lawn, “particularly Africa, there’s been very little progress. The average annual rate of reducing newborn deaths in Africa is less than one percent per year. It’s almost the same as no change.”

At that slow rate of progress, Lawn says it’ll take 155 years for African babies to have the same chance of survival that babies in high income countries have today.

The WHO / Save the Children report cites three main causes of newborn deaths. The first is pre-term delivery, being born too early.

“Doing simple things, like keeping them warm, feeding them better, treating infections, would save them,” she said.

The second leading cause of death for newborns is complications during delivery. “So lack of care at the time of birth, having a midwife, having access to safe care at birth would save the baby and the mother,” said Lawn.

A midwife saved her life.

“I’m a baby born in Africa. I was born in the bush of northern Uganda and my mother had complications in childbirth. And she nearly died and I would have died if people hadn’t made a difference,” she said.

She said having more midwives and healthcare workers in rural areas is critical. The third leading cause of death is infection.

“Here simple prevention – not delivering a baby onto a dirty floor, not putting dirty things on the cord, breastfeeding the baby, giving antibiotics – these are all things that would save these babies lives,” she said.

Lawn is the head of Saving Newborn Lives, a program of Save the Children. She said more investment is needed. But she says that means investing in the “right things to do” for child and maternal care.

“This is particularly critical for the Millennium Development Goals. We now only have four years left until that target in 2015,” she said.

The report says even the United States is not immune from the problem. It says 19,000 newborns die in the U.S. each year. That’s a higher newborn death rate than 40 other countries.

Hormone Could Restore Fertility in Women with Very Low Body Fat

Hormone Could Restore Fertility in Lean Women

Leptin also appears to reduce risk of bone fractures

VOA Art Chimes | St. Louis, Missouri April 07, 2011

Some women with very low body fat - such as athletes and professional dancers - stop menstruating and have an increased risk of bone fracture. Now, there's increasing evidence that hormone treatments can help these women.
The study involved young women with extremely low body fat and a condition called hypothalamic amenorrhea. It's part of a self-preservation mechanism shared by many species: when the food supply is low, scarce energy is focused on survival, not reproduction.

"These women had stopped having their periods because they were exercising more than usual, or having stress, or a little bit of decreased food intake," says Sharon Chou, a researcher at Beth Israel Deaconess Medical Center in Boston.

In a new study, she and her colleagues tested whether a synthetic form of the hormone leptin could restore normal menstrual periods.

Leptin was discovered in 1994. It is related to the body's reserves of fat, so the hormone was investigated as a possible treatment to curb the appetites of obese people. That didn't work, but subsequent research found that leptin does play an important role in regulating how the body responds to lower food supplies.

Researchers found women with hypothalamic amenorrhea had low levels of leptin, and a 2004 study suggested that treatments with synthetic leptin (metreleptin) could restore menstruation. This latest research confirms that finding with a larger, more scientifically-rigorous study.

Nevertheless, Chou says the research is still a work in progress, so doctors won't be doing leptin treatments in the immediate future.

"But the idea is, these women can regain their menstrual cycle, menstrual function. And then, we're also looking to see if, used over a longer time period - perhaps one or two years - if these women would regain some of their bone loss."

The paper describing the effectiveness of leptin treatments by first author Sharon Chou, senior author Christos Mantzoros, and colleagues, is published online in the Proceedings of the National Academy of Sciences.

 

Hormone Could Restore Fertility in Lean Women

Article from VOA

Complications of Pregnancy and Childbirth - Steps Can Help Save Women's Lives

Health Advocates Say Simple Steps Can Save Women's Lives

Melinda Smith January 27, 2011 - VOA

Photo: VOA

A nurse-midwife tells women steps they can take to reduce the risks of dying from complications of pregnancy and childbirth, January 2011

Each year at least 300,000 women - a majority of them in developing countries - die from complications of pregnancy and childbirth, particularly from hemorrhaging after birth. Maternal health advocates gathered in Washington, D.C., this week to share ideas that help save women's lives.

In a perfect world, every baby and new mother would have a safe delivery. The opposite is true, however, for hundreds of thousands of women every year.

That's why the United Nations Secretary-General Ban Ki-moon has declared maternal health and the reduction of maternal mortality by the year 2015 one of the U.N.'s Millennium Development Goals. "A woman dies every minute. This is just [an] unacceptable situation in the 21st century. We must stop the situation."

But women's health advocates at this conference in Washington say a majority of these deaths could be reduced if women got prenatal care and insisted on the help of a skilled birth attendant or midwife.

Deborah Armbruster, a nurse-midwife now with the U.S. Agency for International Development, said, "If we can get women to use skilled attendants who would recognize, you know, that they've got a postpartum hemorrhage, then they can take care of the problems and we won't have women dying, and we won't have such serious morbidities that happen related to that."

Armbruster said women and their birth attendants often prefer to have the baby at home rather than go to a health clinic. And they frequently wait too long before getting help. Once the decision to seek help is made, there are other complications: traveling to the clinic can be dangerous over rough roads, not having the money to pay for medical help, as well as finding the medical facility with a shortage of blood for transfusions.

Like many others in developing countries, women in Bangladesh prefer to have their babies at home. To make that safer, Dr. Shabnam Shahnaz said pregnant women there receive a safe delivery kit, which includes a mat made of absorbent material.

As this training video illustrates, the women lay on the mat as they give birth. If the mat is soaked to the edges, they know to get help immediately because the woman has lost a critical amount of blood.

Dr. Shabnam Shahnaz of Pathfinder International in Bangladesh said, "She would have about two hours to get transferred to a nearby facility." Then she  she would go into shock or die.

Other simple means of trapping the blood range from use of a rubberized mat that funnels blood into a container, as well as a neoprene fabric that wraps tightly around the body. The anti-shock garment stabilizes the patient as she waits for help.

There are drugs that help contract the uterus and prevent further bleeding. Dr. Shahnaz said these are in ready supply, but often are held up by local bureaucracy. "The government has these in their supply. It is in their stock. It's easily available in the market."

Shahnaz differs from some health advocates who call for more training of birth attendants and doctors. What's really needed, she said, is for women to be in control of their own care. "To ask the doctors, 'Why aren't you giving it to me?  This is needed.  I know it is needed.  I know these are the steps that need to be taken.  Why didn't you do it?'  I think this is very, very critical."

Health Advocates Say Simple Steps Can Save Women's Lives - article and video from VOA