brain damage in smaller preemies
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Smaller preemies born in specialist hospitals are more likely to be dead or have a severe brain damage, a UK study suggests. Extremely premature children born in hospitals that lack the necessary specialized care.


Researchers studied data from 2008 to 2015 on 17,577 babies who were born in England prior to 28 weeks of gestation. In particular, some 62% of these babies were born and remain in specialized neonatal hospitals in so called tertiary hospitals; another 12% were moved to tertiary hospitals after 48 hours; 15% were born and remain in neonatal hospitals in local hospitals.

The study found that babies who were born in tertiary hospitals were more than twice as likely to experience severe brain injury and were less likely to survive without brain damage as babies moved to tertiary hospitals immediately after birth.

More than babies born in a tertiary hospital, children who were born in local neonatal hospitals and held in hospital were 34% more likely to die.

“This research is extremely meaningful since it demonstrates that preterm babies born in non-tertiary institutions do indeed have a higher risk of mortality and premature babies moved after birth are more vulnerable to brain injury,” said Dr. Colm Travers, an assistant professor of pediatrics in Birmingham, University of Alabama who co-authored a studied editorial.

“This study suggests that women threatened premature pregnancy, before being delivered to the child, should be moved to tertiary facilities wherever possible,” Travers said by email.

Pregnancy normally takes about 40 weeks, and the full term is considered for babies born 37 weeks after pregnancy. In the weeks immediately after birth babies born before 37 weeks often have difficulty breathing and digest. We can also face long-term problems, such as vision impairment, hearing impairment, memory, and social and compartmental issues.                        

About a baby in 20 high-income countries has the worst possible survival chance and the highest risk for complications and severe disabilities if born less than 28 weeks before birth, the researchers say in BMJ.

Tertiary hospitals have facilities to treat both childbirth and occupational complications and a wide range of acute health problems immediately after birth.

Babys born after 28 weeks of gestation in the United Kingdom are often treated by local neonatal units or moved as soon as possible to tertiary hospitals. The study team states.

Transfers will help them achieve the treatment they need to reduce the risk of brain injuries and other problems that could be fatal, Dr. Chris Gale, co-author of the study and physician at Imperial College London and Chelsea and Wester Hospital NHS Foundation Trust, said.

“Seeing babies are more vulnerable, they need to be carefully monitored and protected after birth,” Gale wrote. Because the babies ‘ lungs are immature, they may need a mechanical ventilator or respiration aid and require close supervision by specially trained neonatal physicians, says Gale. “It affects all of their bodily systems but in particular their lungs and their brain.”               

“The brains of severe preterm babies are also very fragile, particularly some vessels of the blood inside the brain,” added Gale. These are not as shielded from the rest of the baby’s blood pressure changes as they are in terms of children, adolescents, or adults, and therefore extremely premature babies are at much higher risk of breaking through these fragile blood vessels that could lead to brain bleeding.’


Source : Reuters

Published by Neha

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