INFANT MORTALITY : HOW SCIENTIFIC ADVANCEMENTS ARE SAVING BABIES’ LIVES

In recent years, remarkable advancements in medical technology and health practices have significantly decreased infant mortality rates.

Infant mortality is the death of infants under the age of one year. It is a critical indicator of a society's overall health and well-being. This measure helps us understand the effectiveness of healthcare systems, especially in prenatal and neonatal care.

Innovations in neonatal care, such as delayed cord clamping, sophisticated incubators, improved neonatal intensive care units, and advanced prenatal screening methods, have saved countless young lives and enhanced their quality moving forward.

This blog addresses recent and future advances in reducing infantile mortality, such as delayed cord clamping and improved screening methods.

Historical Perspective on Infant Mortality

The history of infant mortality reveals a sobering reality of high infant mortality rates. In ancient times, limited medical knowledge and primitive practices led to many infant deaths.

As we progressed to the era of the Industrial Revolution, there were slight improvements in infant survival. However, rampant poor living conditions and widespread infectious diseases continued to pose significant threats to infant health. Healthcare disparities such as lower socioeconomic status and restricted access to healthcare significantly impacted the survival rates of infants in the past. An absence of specialized care for premature and sick newborns was another major cause of high infant mortality rates.

A transformative era began in the 20th century with the advent of modern medicine. Vaccinations, antibiotics, and improved hygiene practices significantly decreased infant mortality rates. Additionally, enhanced living standards and better nutrition contributed to the health and well-being of infants.^[1]

One practice that emerged during this time was delayed cord clamping.

Delayed Cord Clamping: A Lifesaving Measure for Premature Babies

Delayed cord clamping is a procedure that has been around for a while despite losing popularity since the beginning of the 20th century.

Experts have reconsidered it in recent years, with growing evidence supporting the benefits of delayed clamping, such as increased overall blood volume and improved iron stores in newborns.

The American College of Obstetricians and Gynecologists recommends delaying the clamping of the newborn’s umbilical cord for 30–60 seconds post-birth.^[2] This delay helps supply more oxygen and antibody-rich blood to the newborn. If cord clamping ensues within 10–15 seconds after birth, 67% of the blood reaches the baby. This transfer increases to 80% at one minute after delivery. ^[3]

For premature babies, this delay can reduce serious, life-threatening complications. In full-term babies, it decreases the risk of iron deficiency at 3–6 months, crucial for their health and development.

New research suggests that the benefit of delayed cord clamping is more significant than previously thought and should be reinstated as a standard practice.

As explained in an article from Scientific American titled "Waiting to Cut the Cord Boosts Premature Babies' Survival," delayed clamping and cutting of the umbilical cord has been found to substantially lower mortality risk in premature babies.

After reviewing several publications assessing over 10,000 newborns, researchers recommend waiting at least two minutes before clamping the cord, a duration longer than current public health guidelines suggest. Many routine medical interventions and checkups can be performed with the cord intact, indicating a return to older practices in certain aspects of neonatal care.

Rapid clamping is necessary in certain instances, such as during newborn resuscitation or a condition where the baby is born with a severed cord (abruptio placenta).

Benefits of Delayed Cord Clamping in Premature Infants

Aside from lessening the worldwide impact of premature death, the benefits of delaying cord cutting by longer than the first minute of life can include:

• Increases Blood Volume: Delivers more blood from the placenta to the baby, increasing the newborn's blood volume.
• Boosts Iron Reserves: Enhances iron stores crucial for healthy development.
• Improves Oxygen Supply: Helps in better oxygenation of the baby's organs.
• Reduces Anemia Risk: Lowers the risk of iron-deficiency anemia in infancy.
• Enhances Circulatory Stability: Stabilizes the baby's blood circulation after birth.
• Supports Brain Development: Improved blood and iron supply supports brain development. According to one study, 4-year-old children grew with improved motor control and social skills after delayed cord cutting at birth.^[4]
• Decreases Prematurity Complications: Reduces the likelihood of complications in premature infants.
• Strengthens Immune System: Transfers maternal antibodies, aiding the immune system.
• Improves Respiratory Function: Assists in the transition to newborn breathing^[5].
• Reduces Need for Blood Transfusion: Decreases the probability of blood transfusions in preterm infants.

Despite promising results, further research is necessary to prove the benefits and assess the lifelong impact of delayed cord clamping in infants.

Other Advances and Innovations in Reducing Infant Mortality

Recent advancements in infant mortality prevention encompass better screening technologies, improved global healthcare access, and widespread education.

Neonatal Intensive Care Units (NICUs) have seen significant technological and procedural innovations, enhancing the survival chances of premature and critically ill newborns.

These innovations have improved worldwide screening and diagnostics, particularly for rare diseases that impact infantile survival.

One example would be the Neonatal screening initiative.

Neonatal screening is a crucial healthcare program that detects and treats rare diseases in newborns by testing for various inherited conditions. In 2021, it identified rare diseases in approximately 1 in every 10,000 screened babies, equating to a diagnosis every 15 minutes and about 38,000 infants receiving timely treatment.^[6]

Despite these efforts, only one-third of global newborns are screened, often for a limited number of conditions. There's a critical need to expand neonatal screening worldwide and standardize screening protocols to ensure more comprehensive and equitable healthcare for newborns.

Other areas contributing to lower mortality rates include:

• Improved Healthcare Access: Improved access to healthcare services for at-risk populations has played a crucial role in reducing infant mortality ensuring early and comprehensive prenatal care.
• Telemedicine: The rise of telemedicine offers remote monitoring and consultations, which are especially beneficial for expecting mothers in remote areas or those with limited access to traditional healthcare facilities.
• Breastfeeding Support and Education: Enhanced focus on breastfeeding support and education aids in promoting infant health, offering nutritional benefits, and strengthening the immune system of newborns.

Paving the Way Forward: The Next Frontier in Infant Health

The future for preventing infant mortality is bright. Some avenues currently being explored include gene therapy, better diagnostics, and other advanced treatments.

Gene therapy holds the promise of revolutionizing infant care by potentially preventing certain genetic disorders that contribute to infant mortality. This innovative approach involves correcting or replacing defective genes, offering a beacon of hope for many infants facing life-threatening genetic conditions.

Many therapies are still in clinical trials and are unavailable to infants. However, there have been a few breakthroughs in recent years that have contributed to lowering mortality rates, such as gene therapy for infants with cystic fibrosis.

Other research efforts have focused on the following areas of pediatric medicine:

1. Advancements in Maternal-Fetal Medicine: Continuous progress in this field aims to improve the health of both mother and child during pregnancy, reducing risks associated with premature births. A promising approach relates to placental rejuvenation, which aims to limit placental damage that contributes towards restricting fetal growth.^[7]
2. Vaccine and Treatment Breakthroughs: Developing vaccines and treatments for diseases disproportionately affecting infants is a prime focus. These efforts include tackling conditions like respiratory syncytial virus (RSV) and other infections.^[8]
3. Leveraging Technology: Integrating advanced technology into neonatal care enhances monitoring and treatment capabilities, leading to better health outcomes.

Managing and improving access to medical care, socioeconomic status, and education is crucial in reducing infant mortality rates. Several local and global initiatives attempt to provide equitable healthcare access for all families and infants.

Creating effective policies and fostering collaboration among healthcare providers, researchers, and policymakers is essential. This cooperative approach is vital to further diminishing infant mortality rates globally.

Conclusion

We have seen remarkable advancements in combating infant mortality, from neonatal care innovations to prenatal screenings. These strides represent significant progress in ensuring healthier beginnings for our youngest and most vulnerable.

The fight against infant mortality is ongoing. A comprehensive, multi-disciplinary approach is vital in addressing this issue. Continued research, education, and policy enhancements are crucial. Every stakeholder, from healthcare professionals to policymakers, plays a vital role in this endeavor. If you have questions regarding pregnancy or labor, confer with qualified neonatologists or pediatricians for personalized medical advice and infantile care.

To search for the best pediatric healthcare providers in Germany, India, Malaysia, Singapore, Spain, Thailand, Turkey, the UAE, the UK and The USA, please use the Mya Care Search engine

To search for the best healthcare providers worldwide, please use the Mya Care search engine.

Sources:

Disclaimer