Angelika Berger and Arnold Pollak from the Children’s Department at the MedUni Vienna will be presenting the news of this success at the international Premature Babies Day on 17th November. One in ten children worldwide is born prematurely.
In the Department of Neonatology, Paediatric Intensive Care Medicine and Neuropaediatrics at the MedUni Vienna within Vienna General Hospital, a concept developed in Cologne has been used for two years in the immediate care of extremely premature babies in which a substance known as a surfactant, which is essential for life, is administered to new-born babies who breathe spontaneously without any need for artificial respiration. Sufficient autonomous surfactant formation only begins from around the 28th week of pregnancy, and from the 34th week the substance is produced in adequate quantities in most cases. Surfactant is an emulsifying, surface-active substance that helps to keep the alveoli of the lungs open.
Better chances of survival, fewer complications later on
With this method, the surfactant is administered gently via a thin probe on the spontaneously-breathing child. Until now, premature newborn babies had to be intubated and ventilated in order to prevent acute respiratory distress syndrome (ARDS), caused by a lack of the body’s own surfactant. “Most of even the most premature babies manage, after having been given this surfactant, to breathe adequately on their own – without any need for artificial respiration,” says Angelika Berger, Interim Head of the Department of Neonatology, Paediatric Intensive Care Medicine and Neuropaediatrics, on Thursday at the press conference held at the MedUni Vienna.
By using this new method, the MedUni Vienna has increased the survival rate of children who are born 17 to 13 weeks before their due dates, to over 80 per cent. This is regarded internationally as an absolutely excellent achievement, as the statistics from the “Vermont Oxford Network”, a network of hundreds of neonatologists, confirms. Arnold Pollak, Director of the University Department of Paediatrics and Adolescent Medicine, also reports an additional positive effect: “This new method has also enabled us to reduce the later complications arising from artificial respiration, such as chronic damage to the lungs or brain.”
In 2010, 92 children were cared for at Vienna General Hospital who were born between the 23rd and 27th weeks of pregnancy, i.e. up to 17 weeks too early. Says Pollak: “This is an extremely high number. In the German-speaking region, there is no other centre that looks after this high number of extremely premature babies.” The focus of resources on premature baby care is also considerable – both in terms of manpower and finance. Pollak: “It’s an investment that’s well worthwhile, as you can see.”
One in ten children worldwide is born prematurely. In Austria, the rate stands at 11.1 per cent. In 1990, 8.1 per cent of babies were born before the 37th week of pregnancy. The number of live births, however, fell during the same period from 90,454 to 76,344. Therefore around 8,000 babies are born each year in Austria before their due date.
Aftercare needed from the public sector
There may be one of the most comprehensive and dedicated aftercare programmes available at the University Department of Paediatrics and Adolescent Medicine at the MedUni Vienna, “but premature babies have no right to standardised care similar to the mother-child pass examinations,” warned Berger on Thursday. “There is a consensus paper from the Austrian Society for Paediatric and Adolescent Medicine which sets out precisely what that aftercare should provide. At the moment, however, it depends very much on the hospital management’s personal involvement – even after the child has been discharged.” The follow-up of these children, however, needs to continue in some cases until they reach primary school and beyond, says the scientist. Currently, there is a parent’s association being founded that will act as a contact point for families with premature babies.
“The problems begin for babies and their mothers after they are discharged from hospital”
One of the founders of this parent’s association is Andrea Emberger, who is herself a mother of a premature baby – her now two-and-a-half year old daughter: “The care in the paediatric clinic was perfect, both medical and psychological. The problems start afterwards, when the rehabilitation begins. That’s when the resources are lacking.”
But it’s not just the children, but their mothers too who need further support after being discharged from the watchful eye of the doctors, says Emberger, who speaks from experience. This support isn’t currently in place. “I paid for my psychological follow-up myself and spent my own money to rebuild my psychological wellbeing.” In Andrea Emberger’s case, a simple infection had brought on her daughter’s premature birth. Her call is for “better education and information about the risk factors of a premature birth even during pregnancy.”
Information on the “Parents for Premature Babies” initiative: www.eine-handvoll-leben.at