The Foundation Smile de Ángel held the IV Virtual Symposium You drink Premature: Prevention, Innovation and Challenges in Comprehensive Care, with national and international experts to analyze the current state of prematurity and advances in neonatal and gynecological-obstetric care in Latin America and the Dominican Republic.
Ann Bianchigynecobstetrician and coordinator of the Committee of the Latin American Federation of Societies of Obstetrics and Gynecology (Flasog), presented the topic “Panorama of prematurity in Latin America: Innovations, challenges and perspectives from gynecology-obstetrics in the region”, where she highlighted that “more than 90% of you drink premature extremes die in the first days of life in low-income countries, while less than 10% occur in high-income ones.”
“In low-income countries the main causes of delivery premature They include infections, malaria, HIV, syphilis and high rates of teenage pregnancies. In modifiable causes to prevent delivery pre term are found complications obstetric, fetal, maternal medical conditions without medical indications and those based on experience and not evidence-based medicine,” he revealed through a press release.
“We have to reduce the rate of delivery preterm iatrogenic, which is increasing in the world and represents 30% to 35.5%. In some countries it is more than 50%. This is performed before 37 weeks of pregnancy, by induction of delivery or a cesarean section in the absence of labor delivery spontaneous or ruptured membranes,” he said. Bianchi.
Likewise, he recalled that, today, the assisted reproduction technique is more common with the consequence of the increase in multiple gestations and teenage pregnancy. In this sense, he called for “decreasing the rate of cesarean sectionsbecause it has really become a global epidemic and the complications “They’re huge.”
The specialist emphasized the need to design and implement policies of health and develop strategies effective of prevention and short- and long-term management, improve coverage and quality of basic care for all mothers and their newborns.
Additionally, doctors, nurses, and midwives must receive training to care for premature.
As innovations, Bianchi showed the adoption of care models to improve the forecast of the delivery preterm promoted by the Figo Group, which include the appropriate use of antenatal corticosteroids, prior to 34 weeks; magnesium sulfate for neuroprotection of the fetus, delayed cord clamping, breast milk feeding and kangaroo care. He also emphasized the need to “audit births premature between 24 and 34 weeks to determine its causes and the actions of the doctors that could have prevented it,” he indicated.
Increase in prematurity in the DR
For her part, Dr. Taina Malena, neonatologist and neonatal coordinator of the National Health Service (SNS), addressed the policies public in the Dominican Republic: the preventionchallenges and advances in neonatal care of prematurity.
He indicated that the birth rate premature in SNS hospitals per year, from 2018 to 2023, shows “a progressive increase of 7% to 10% annually, which calls for concern. In 2018, 5,357 births were registered prematurewhile in 2023 it reached 8,054,” said Malena.
He pointed out that the sepsis It is the second cause of death in premature and especially those associated with the care of health.
“In 2024, there are hospitals where 68%, 63%, 58% of children who die are foreignersand, of these, 60% are prematurewhose mothers did not receive prior checkups,” he added.
The policies Public measures to reduce neonatal morbidity and mortality implemented by the SNS cover 30 Neonatal Intensive Care Units (NICU) with more than 400 beds available, 85% of these units have compressed air. Inclusion of various programs, such as the milestone of 23 kangaroo mothers, 10 in prevention of respiratory syncytial virus (RSV), screening with 14 for visual checks and eight for hearing, the specialist listed. Additionally, all units have surfactant, prenatal steroids, magnesium sulfate, caffeine, and parenteral nutrition.
“As an innovation in the region, the SNS implements the surveillance and control of Health Care-Associated Infections (HAI), which included the creation of single-dose centers under a laminar flow hood in eight maternities, which managed to reduce by one 43.3% deaths due to septic shock in four maternity hospitals during 2024, compared to the previous year,” he noted.
Damage neurological
Dr. Roberto Nina, president of the Dominican Society of Obstetrics and Gynecology, addressed the comprehensive vision of gynecology-obstetrics in the prevention of prematurity: challenges and strategies from clinical practice in the Dominican Republic.
He explained that, according to the American College of Gynecology and Obstetrics, in the case of prematureamong survivors only 1% do so without damage neurological. More than a million who survive asphyxiation have cerebral palsy and learning disabilities.
The risks of childbirth premature They involve pregestational, gestational, fetal, and uterine maternal factors. The strategies birth prevention premature They include “early detection of infections such as urinary tract and bacterial vaginosis; monitoring of cervical length with use of transvaginal ultrasound and cerclage if necessary,” Nina explained.
“The use of progesterone in pregnant women with a history of delivery premature or short cervix; close monitoring of maternal conditions with control of preeclampsia, hypertension and gestational diabetes; nutritional counseling for pregnant women for adequate nutrition and supplementation such as folic acid; reduction of modifiable risk factors such as educating them to avoid tobacco, alcohol and other substances,” he advised.
He stressed the importance of carrying out “rigorous prenatal check-ups on pregnant patients, adhering to protocols and carrying out joint clinical management of prematurity, to reduce the alarming numbers we have at the moment.”
Gladis Abreu, manager of the Foundation Smile de Ángel, stressed the importance of the symposium, as a space to “provide purposeful reflections and make visible concrete actions for the benefit of premature and their families; delve into policies public, strategiesactions, challenges and limitations, and get closer to good clinical practices aimed at significantly improving the living conditions of patients. premature and their families.”
