Editor’s Note
Brankica Vasiljevic
Abstract
Each year 15 million babies are born preterm (<37 weeks of gestation (GA)) worldwide and their survival chances vary dramatically around the world. Most premature babies (>80%) are between 32 GA and 37 GA (moderate/late preterm). About 10% of preterm babies are born 28 to <32GA. Survival gap for preterm babies born in high-income countries and babies born in the low-income countries has widened dramatically. Multiple gestations are at increased risk for preterm delivery, intrauterine growth restriction, congenital anomalies and higher incidence of perinatal death. Prematurity is the leading cause of neonatal mortality and morbidity. Over 1 million children die each year due to complications of prematurity. Mortality is inversely proportional to birth weight (BW) and GA. Advances in neonatal intensive care during the last decades has decreased mortality in premature babies but morbidity is still high (at least 20-50%), especially in extreme preterm babies (<28 GA). The major neurodevelopmental morbidities (mental retardation, cerebral palsy, seizure disorders, hydrocephalus, visual or auditory impairment) in extreme preterm infants occur in approximately 20-30% survivors. Neonatal mortality rate for twins is 5 times more than in singletons. Discordant twins are present in 25% twins pregnancy (10x greater than singletons). In discordant small twins (IUGR) mortality is 6 times more than in concordant twins. Incidence of congenital anomalies is significantly related to the level of discordance (IUGR). Systematic team approach and safe and effective transport of high-risk mothers and newborns is an essential component of regional perinatal care and the goal is to provide the required level of specialized care.