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Preterm birth drug underused

Wednesday August 13th, 2014

Simple drugs that could prevent birth complications are being under-used in much of the world, experts warn today.

The researchers highlight the low uptake rates in low-income and middle-income countries of steroid injections that can improve outcomes for premature births.

Dr Joshua Vogel of the World Health Organisation in Geneva, Switzerland, and colleagues carried out an international study of over 303,000 births in 29 low- and middle-income countries. Just 52% of the women who went into labour prematurely, and were eligible for the simple, effective, low-cost steroid injection to prevent death and disability in their newborn babies actually received it.

Rates in certain countries were higher than others. For example, 91% of eligible women in Jordan received the injection, compared with 16-20% in Afghanistan. Full details are published in The Lancet today (13 August).

Dr Vogel said: "Giving antenatal corticosteroids to women at risk of preterm birth is one of the most effective treatments for reducing newborn death and illness. More than three-quarters of premature babies could be saved with cost-effective interventions such as antenatal corticosteroids.

"This is particularly important in Africa and Asia where more than 60% of preterm deliveries occur and where resources are scarce and it is difficult to provide expensive neonatal care."

But in a commentary, Dr Stuart Dalziel of The University of Auckland, New Zealand, added that antenatal corticosteroids "are not the panacea for preterm mortality in low-income and middle-income countries".

Instead, they say the focus should be on a set of simple measures to cut premature labour and reduce the impact. These include family planning, access to antenatal care, antibiotics for premature rupture of membranes, immediate care for all babies, and effective neonatal resuscitation.

Vogel, J. P. et al. Use of antenatal corticosteroids and tocolytic drugs in preterm births in 29 countries: an analysis of the WHO Multicountry Survey on Maternal and Newborn Health. The Lancet 13 August 2014 doi: 10.1016/S0140-6736(14)60580-8

Tags: Childbirth and Pregnancy | Nursing & Midwifery | Pharmaceuticals | Women’s Health & Gynaecology | World Health

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