Marcela Valente
BUENOS AIRES, Oct 7 2010 (IPS) – My name is Maximiliano Muñoz. I m 23 and I m studying engineering, says the young man smiling into the camera. The television spot is part of an awareness-raising campaign in Argentina on the rights of people born prematurely.
Preemies Week poster Credit: Unicef Argentina
The campaign, coordinated by the United Nations Children s Fund (UNICEF), was launched Monday in more than 70 of the country s maternity hospitals and runs through Friday, featuring workshops, festivities and family reunions. It supports the right of preemies to be recognised as unique beings.
Muñoz, a student at the National University of Salta in northwest Argentina, says he was born in the fifth month of gestation, at 21 weeks. My parents tell me they went through a very distressing time, but they came through it and now I live a normal life, he said. Other young people said they had been told they could fit in a shoebox or sleep in the crook of one arm.
Their stories, some of the 10 collected for the campaign, show that with the right care, premature babies born before the 37th week of gestation and weighing less than 2,500 grams have a very good chance of living a life free of after-effects.
In Argentina there are about 750,000 live births a year, of which eight percent are preterm. This is close to the Latin American average, but higher than the European average of 6.2 percent.
Argentina s infant mortality rate (deaths of infants aged under one year) was 12.5 per 1,000 live births in 2008, and half of the fatalities were premature infants. Progress has been made, but it has not been satisfactory for babies with very low birth weights or under 1,500 grams.
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In developed countries, these infants survive, Zulma Ortiz, a UNICEF health and nutrition expert, told IPS. Here the survival rate is better than it was, but if they are still dying, something is going wrong.
The campaign is highlighting the lower opportunities for survival and for avoiding serious after-effects among preemies born to poor families without access to prenatal checks, who live far away from urban centres.
In this South American country, between 2000 and 2008 the mortality rate of babies weighing 2,000 to 2,500 grams at birth fell 34 percent, and dropped 37 percent for those with birth weights between 1,500 and 1,999 grams. However, among newborns weighing under 1,500 grams the mortality rate declined by only 23 percent.
One of the campaign goals is to reduce the mortality rate of preterm infants, Andrés Franco, UNICEF representative in Argentina, told IPS. But it s not just about saving their lives, he stressed.
Franco said the campaign, Semana del Prematuro (Preemie Week), is the first of its kind, and was the idea of the director of an Argentine public hospital, which UNICEF subsequently developed. If successful, it could be replicated in other countries, he said.
As the infant mortality rate falls due to more births taking place in hospitals, fewer cases of diarrhoea in children, etc., new challenges come to the fore, like those associated with prematurity, which Argentina is facing at this stage of its development, Franco said.
This kind of challenge will eventually make its appearance in other countries in the region, like Colombia, Mexico and Venezuela, or in Africa and Asia, where infant mortality rates are higher, he said.
Among the causes of preterm births that the campaign is targeting are teen pregnancies, often combined with abuse of substances like alcohol or drugs, and overly short (under two years) intervals between pregnancies.
The campaign is also alerting the community that mothers at high risk of preterm delivery have the right to demand corticosteroid injections, which accelerate the development of the unborn child s respiratory system.
In Europe this treatment is given in 80 percent of cases at risk of premature birth, whereas here only 50 percent are treated, although the medication is not expensive and would prevent a lot of problems, Ortiz complained.
Gabriela Bauer, at the public Garrahan Children s Hospital in Buenos Aires, described the importance of close contact with the families of preterm newborns, who should be closely monitored to age six.
Bauer, a paediatrician, explained that during the first year of life, feeding and nutritional problems may arise, and the greatest dangers are respiratory infections which can be fatal in small babies with immature immune systems.
UNICEF wants to promote the practice in maternity hospitals of placing the family at the centre of care for the first year of the baby s life, including the mother as the chief monitor of her child s health, as well as other direct family members who can begin offering support while the premature baby is still an in-patient.
Public maternity hospitals have a number of problems, such as a shortage of doctors and nurses specialised in neonatology. Neonatal intensive care units should have one neonatal nurse for every patient, but in fact there is only one nurse for every three newborns, according to the Ministry of Health.
When the baby is discharged from hospital, another stage begins, say a couple with a two-year-old child in another of the television spots. The child must be evaluated for speech disorders or more serious after-effects that affect between 10 and 15 percent of preemies. These consequences may range from cerebral palsy to delayed development and impaired vision and hearing. At the age of three, if after-effects have not appeared before, the preemies may begin to experience learning difficulties, Bauer said.
The child may have difficulty concentrating, performing math problems, or reading fluently. These are common symptoms linked with premature births, and can be remedied if adequate follow-up is given at this stage, she said.
Parents who have to cope with permanently disabled children can be offered advice about rehabilitation centres, special help and their right to state allowances during the follow-up process.
The week s activities include visits by adults who were born prematurely to neonatal care wards where parents are just encountering the complicated e problems that the former preemies, not without effort, have managed to overcome.
Well-known personalities who were born preterm have joined the campaign, including football star Carlos Teves who plays for Manchester City and the Argentine national team, as well as organisations like the Asociación Argentina de Padres de Niños Prematuros (APAPREM), a self-help group for parents of preterm infants.
