TY - JOUR
T1 - New World Health Organization recommendations for care of preterm or low birth weight infants
T2 - health policy
AU - Care of Preterm or Low Birthweight Infants Group
AU - Darmstadt, Gary L.
AU - Al Jaifi, Nafisa Hamoud
AU - Arif, Shabina
AU - Bahl, Rajiv
AU - Blennow, Mats
AU - Cavallera, Vanessa
AU - Chou, Doris
AU - Chou, Roger
AU - Comrie-Thomson, Liz
AU - Edmond, Karen
AU - Feng, Qi
AU - Riera, Patricia Fernandez
AU - Grummer-Strawn, Lawrence
AU - Gupta, Shuchita
AU - Hill, Zelee
AU - Idowu, Ayede Adejumoke
AU - Kenner, Carole
AU - Kirabira, Victoria Nakibuuka
AU - Klinkott, Reinhard
AU - De Leon-Mendoza, Socorro
AU - Mader, Silke
AU - Manji, Karim
AU - Marriott, Rhonda
AU - Morgues, Monica
AU - Nangia, Sushma
AU - Portela, Anayda
AU - Rao, Suman
AU - Shahidullah, Mohammod
AU - Tran, Hoang Thi
AU - Weeks, Andrew D.
AU - Worku, Bogale
AU - Yunis, Khalid
N1 - Publisher Copyright:
© 2023
PY - 2023/9
Y1 - 2023/9
N2 - Approximately 11% of infants are born preterm, and complications of prematurity are the most common cause of death in children aged under five years. Almost one million preterm infants die each year across low, high and middle income countries. In 2021, the World Health Organization (WHO) convened a Guideline Development Group (GDG) to examine evidence and formulate recommendations for care of preterm or low birthweight (LBW) infants according to WHO Guideline Review Committee (GRC) criteria. GRADE methods were used to assess the certainty of evidence and the GDG developed judgements using the DECIDE (Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence) framework. Twenty-five recommendations were made; 11 recommendations were new, and 16 were for preventive and promotive care. Kangaroo Mother Care (KMC) was recommended to start immmediately after birth as routine care for all preterm or LBW newborns (except for critically ill infants who are in shock, unable to breath spontaneously after resuscitation, or require ventilatory support) both in the facility and at home. New recommendations were also made for caffeine to treat apnoea and for extubation; family involvement in routine care for preterm or LBW infants; and for post-discharge home-visit follow-up care. New recommendations were also made to consider use of probiotics, emollient therapy, caffeine for prevention of apnoea, continuous positive airway pressure (CPAP) immediately after birth (with or without respiratory distress) in infants less than 32 weeks gestational age; and for family support to enable the care of preterm or LBW infants. The recommendations confirm the pivotal role of preventive and promotive care for preterm and LBW infants, especially the importance of keeping the baby and mother together, and empowering and supporting families to care for their preterm or LBW infant. WHO is now working to help scale up care for small and sick newborns, including organizational shifts in all ‘health system building blocks’ such as infrastructure, commodities, workforce and monitoring. Funding: Nil.
AB - Approximately 11% of infants are born preterm, and complications of prematurity are the most common cause of death in children aged under five years. Almost one million preterm infants die each year across low, high and middle income countries. In 2021, the World Health Organization (WHO) convened a Guideline Development Group (GDG) to examine evidence and formulate recommendations for care of preterm or low birthweight (LBW) infants according to WHO Guideline Review Committee (GRC) criteria. GRADE methods were used to assess the certainty of evidence and the GDG developed judgements using the DECIDE (Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence) framework. Twenty-five recommendations were made; 11 recommendations were new, and 16 were for preventive and promotive care. Kangaroo Mother Care (KMC) was recommended to start immmediately after birth as routine care for all preterm or LBW newborns (except for critically ill infants who are in shock, unable to breath spontaneously after resuscitation, or require ventilatory support) both in the facility and at home. New recommendations were also made for caffeine to treat apnoea and for extubation; family involvement in routine care for preterm or LBW infants; and for post-discharge home-visit follow-up care. New recommendations were also made to consider use of probiotics, emollient therapy, caffeine for prevention of apnoea, continuous positive airway pressure (CPAP) immediately after birth (with or without respiratory distress) in infants less than 32 weeks gestational age; and for family support to enable the care of preterm or LBW infants. The recommendations confirm the pivotal role of preventive and promotive care for preterm and LBW infants, especially the importance of keeping the baby and mother together, and empowering and supporting families to care for their preterm or LBW infant. WHO is now working to help scale up care for small and sick newborns, including organizational shifts in all ‘health system building blocks’ such as infrastructure, commodities, workforce and monitoring. Funding: Nil.
KW - Evidence
KW - Guidelines
KW - Health system organization
KW - Maternal and newborn care
KW - Preventive care
KW - Promotive care
KW - Sick newborn care
UR - http://www.scopus.com/inward/record.url?scp=85171436839&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85171436839&partnerID=8YFLogxK
U2 - 10.1016/j.eclinm.2023.102155
DO - 10.1016/j.eclinm.2023.102155
M3 - Review article
AN - SCOPUS:85171436839
SN - 2589-5370
VL - 63
JO - EClinicalMedicine
JF - EClinicalMedicine
M1 - 102155
ER -