Dr Hitesh A Diar
Newly born babies represent the hopes and dreams of their parents and the nation as a whole. After all, they are the foundation of the future.
In 2000 the United Nations Millenium Summit set specific goals on a global scale, called the Millenium Development Goals (MDGs).
Of relevance is MDG 4, which looks at reducing the under-5 mortality rate. Neonatal deaths comprise a third of this under-5 mortality rate. Ultimately, itís a race against time to reduce the neonatal mortality rate in South Africa by two-thirds by 2015 which will have a positive impact on the under-5 mortality rate.
However, we are not doing well. The Neonatal Mortality rate in South Africa as quoted by the 8th Saving Babies 2010-2011 report was 26.9 per 1000 live-births. Prematurity and intrapartum hypoxia comprise 50% of these neonatal deaths.
Although premature birth cannot always be prevented, interventions such as family planning, counselling, early and appropriate use of available antenatal services as well as adequate management and early referral of high risk pregnancies can be beneficial. Once premature delivery is inevitable, measures such as the use of intrapartum antibiotics, corticosteroids, clean delivery practices have been shown to improve maternal and neonatal outcomes.
Postpartum measures to improve survival of the preterm neonate include appropriate resuscitation of the newborn with the availability of appropriate respiratory support, prevention and management of hypothermia and early establishment of breast milk feeds. Intrapartum hypoxia can lead to brain damage and therefore cerebral palsy, and may be prevented by providing appropriate care of the mother in labour. Timely and adequate resuscitation of the newborn with intrapartum hypoxia and the provision of therapeutic hypothermia to these babies in a controlled environment has been shown to improve their outcomes.
Widespread education and awareness of these measures need to be implemented if we want to see progress in our ultimate goal, which is the reduction of neonatal mortality in South Africa.
Despite resource constraints many newborn babies do survive, be it a premature or a term baby. This is all thanks to the healthcare personnel who dedicate their lives to improving newborn care.
Let us embrace South Africaís future in the form of these newborn babies.
Dr Hitesh Diar is a Paediatrician/Neonatologist at Netcare Rand, Park Lane Hospitals, Joburg