Care of premature neonate: challenges and strategies to improve the neonatal outcome

Prematurity has become a global health problem, Newborn deaths account for 40 percent of all deaths among children under five years of age. Prematurity is the leading cause of newborn deaths especially in the first 4 weeks of life and it is the second leading cause of death after pneumonia in children under the age of five years. The major causes of newborn deaths in India are pre-maturity/preterm (43.7 percent); neonatal infections (20.8 percent); intrapartum-related complications/ birth asphyxia (19.2 percent); and congenital malformations (8.1per cent) and others 8.2%. 15 million premature babies are born annually all over the world and it accounts for more than 1 in 10 babies born preterm. In India, out of 27 million babies born every year (2010 data), 3.5 million babies born are premature. More than 80% of birth occurs at 32-37 weeks of gestation and die needlessly for lack of simple, essential care such as warmth and feeding support. Many survivors face a lifetime of disability, including cerebral palsy, neurodevelopmental delay, learning disabilities, visual and hearing problems. A premature baby requires sophisticate medical and nursing services to reduce neonatal mortality and morbidity. This review highlights the medical and nursing care of premature neonates and strategies to improve the neonatal care.