Researchers Say Most Deaths of Newborns Preventable

16 June, 2014

From VOA Learning English, this is Science in the News.

I'm Anna Matteo.

And I'm Christopher Cruise.
Researchers Say Most Deaths of Newborns Preventable
Nurses hold newborn babies

This week, we report on research that shows most newborn baby deaths could be prevented. Then, we report on the first international plan of action to end newborn deaths. Later, we tell about a call for pregnant and breastfeeding mothers to make sure they are getting plenty of iodine in their diets. And finally, we tell about a possible link between premature birth and a collection of mostly harmless bacteria.

Preventing Newborn Deaths

Five-and-one-half million newborn and stillborn baby deaths are reported every year. But very little money is being spent on efforts to reduce that number. That was one of the findings of a series of papers published in the British medical journal The Lancet. The findings also show almost all those deaths could be prevented.
Top 10 countries for newborn deaths in 2013.
Top 10 countries for newborn deaths in 2013.

Joy Lawn led the research.

"Every year there are 2.9 million babies who die in the first month of life, and most shockingly a million who die on their birth day -- the first day. And there are 2.6 million stillbirths -- most shockingly, 1.2 million who die while the woman is in labor."

Most of the deaths take place in low- and middle-income countries. But Ms. Lawn notes that newborn and stillborn baby deaths are also an issue in rich countries. For example, the United States has about 500,000 pre-term -- or early -- births every year.

Joy Lawn is a professor at the London School of Hygiene and Tropical Medicine. She is also an advisor to the aid group Save the Children UK. She says many babies and their mothers could be saved for just a few dollars in medical care.

"Seventy-one percent of newborn deaths can be prevented with solutions that we have already. Three million women, babies -- counting newborns and stillbirths -- could be saved every year with investments at the time of birth."

That care at the time of birth includes simple things -- like keeping the baby warm and helping him or her learn to breastfeed. Another good idea is to make sure the baby has skin-to-skin contact with the mother.

Professor Lawn says doctors have known for years that many newborns die. But she says spending to prevent the problem remains low.

"Of the billions of dollars that are given for child survival, only 4% of that donor funding even mentions the word ‘newborn.' And yet 44% of under-five deaths are among newborns. So there's a major mismatch in what the funding is going to, compared to where the deaths are now."

Much of the money is spent on preventing deaths of mothers and children up to age five.

In recent years, it has become more common for hospitals in the United States to prepare birth records for stillborn babies. Professor Lawn says it is important for parents to know that their child has been recognized. However, she says researchers found that, in many developing countries, no such record is kept.

More than 50 experts from 28 organizations in 17 countries took part in the research. Their findings were published in the British medical journal The Lancet.

WHO's Plan to Save Millions of Newborn Lives

Melinda Gates, the wife of American businessman Bill Gates, recently made an appeal for the first international action plan to end newborn deaths. She urged delegates to the World Health Assembly in Switzerland to support the Newborn Action Plan.
Every Newborn Action Plan, an international initiative, is set to be launched in June 2014. It's estimated there are 5.5-million newborn and still birth deaths each year. Credit: PMNCH
Every Newborn Action Plan, an international initiative, is set to be launched in June 2014. It's estimated there are 5.5-million newborn and still birth deaths each year. Credit: PMNCH

Health officials agree that many -- perhaps even most -- newborn deaths are preventable. Yet nearly three million babies die each year within their first 28 days of life.

Melinda Gates told the meeting that, by approving the action plan, health ministers can immediately begin saving young lives. The delegates voted to approve the measure.

Ms. Gates told reporters that five low-cost interventions are very effective in saving newborns. They include breastfeeding, stopping and treating infections, and skin-to-skin contact with the mother.

Ms. Gates said three countries -- Ethiopia, Rwanda, and Nepal -- are already putting these steps in place, and reporting some success.

"And simply by using the health care extension worker -- a health community worker platform that they've got -- and focusing on those newborn deaths, they've been able to bring down not just under-five mortality, but newborn death-rates as well. So, we have those as models and the other African nations and other countries around the world are looking at those three countries to learn what is actually possible by focusing on this."

Ms. Gates says the newborn death-rate in Ethiopia has gone down by 28 percent since the country began working on the issue six years ago.

One of the United Nations' Millennium Development Goals is to reduce the number of deaths among new mothers and children under five. Great progress has been made in reaching this goal. But the World Health Organization says South Asia and sub-Saharan Africa still have high numbers of newborn deaths every year. It says India, Nigeria and Pakistan have the highest numbers.

Melinda Gates says many countries neglect the issue of newborn deaths because they are working to reduce the number of women who die during childbirth. Ms. Gates said that if there are problems giving birth, health workers first try to save the mother. She says it is important to make health workers understand that they should work on both the mother and child at the same time.

The Lancet recently published research that shows in most places, more than half of all child deaths are among newborns.

Many Pregnant, Breastfeeding Women Need More Iodine

The American Academy of Pediatrics says pregnant and breastfeeding women should make sure they are getting enough iodine in their diet.

Growing babies -- both before and after birth -- need iodine for brain development. But a new study says about a third of pregnant women in the U.S. are not getting enough iodine, and only 15 percent take pills that give them the important mineral.

The National Academy of Sciences and the American Thyroid Association say pregnant and breastfeeding women should take vitamins that have at least 150 micrograms of iodide. Iodide is a kind of iodine that can easily be taken in by the body. The U.S. Institute of Medicine says a good diet, in addition to vitamin supplements, should give pregnant women 220 micrograms of iodine every day. It says breastfeeding women should take in 290 micrograms.

Iodine is commonly found in fortified salt. But researchers say many women get their salt from processed, or prepared, food. They say this kind of salt does not contain iodine. They urge pregnant and breastfeeding women to get tested and take extra vitamins to make sure they are getting enough of the element.

Women who are thinking about having a child should make sure they have enough iodine because many women do not know they are pregnant early in the pregnancy.

Bad Health, Bacteria in Placenta Could Cause Premature Births

The placenta -- which supports the growing fetus -- may not be as clean as many medical experts once believed. New research suggests the placenta may contain a collection of bacteria that may affect the pregnancy, and even premature births.

Doctors work hard to prevent such births, because the babies often do not weigh very much. If they survive, low-birth-weight infants are at increased risk for health and developmental issues. They may develop cerebral palsy, lung and gastrointestinal problems, and eyesight and hearing loss.

Researchers at the Baylor College of Medicine in Texas studied the placental tissue of 320 women. Most of these women gave birth the traditional way -- without doctors performing an operation. The researchers say they found about 300 different kinds of bacteria in the placenta. Most of them are harmless, and help the baby's health. Until this discovery, experts believed that those harmless, and helpful, bacteria, lived in the mother's vaginal canal and were passed to the baby during birth.

The researchers made another surprising finding. They found that the mix of bacteria in a newborn is not like the bacteria found in the mother's vagina. They were able to link the bacteria in the placentas of women who recently gave birth to microbes in the mothers' mouths.

Kjersti Aagaard led the research team. She says that may explain why women with gum disease often give birth to babies at less than 37 weeks into the pregnancy. The normal pregnancy lasts about 40 weeks.

Ms. Aagaard reported on the study in the journal Science Translational Medicine. She said researchers believe the bacteria from the mouth travelled to the placenta through the mother's blood.

The placenta is connected to the wall of the woman's uterus by the umbilical cord. It is the only organ that forms in adult life and then not used after birth. It feeds the fetus as it develops and provides oxygen. It also removes waste and produces hormones that support the pregnancy.

Kjersti Aagaard says things like smoking and diet have been linked to premature births. Those factors can be controlled by the mother. But other factors -- like what is in the placenta -- cannot be controlled. So women should not blame themselves for giving birth to premature babies.

"In this situation, we really want women to step away from that, ‘I accept the blame for what happened in this pregnancy,' and much more one towards, ‘Well, if there are things that put me at risk for pre-term birth that I can change, then I'm going to do everything in my power to change those.'"

By learning more about the placenta before the child is born, researchers hope to identify women who may be at high risk for pre-term deliveries.

This Science in the News was written by Christopher Cruise, who also produced our report. It was reported by Joe DeCapua and Jessica Berman in Washington and Lisa Schlein in Geneva.

I'm Anna Matteo.

And I'm Christopher Cruise.

Join us again next week for more news about science on the Voice of America.