The low birth weight index has increased almost 1 tenth in one year in Havana, going from 7.95 per 1,000 to 8.04, according to data provided by cubadebate this Wednesday. The official media devotes a wide space to analyze what happened at the Diez de Octubre Gynecobstetric University Hospital Diez de Octubre in the capital, where eight newborns died in just five days in January.
Although the investigation is being carried out, the newspaper interviews Yaima Rodríguez Espinosa, a pediatrician and head of the maternal and child section of Havana, who explains in greater detail what happened at the medical center.
Rodríguez Espinosa divides the deceased into two groups, four of the newborns are associated with sepsis events, but the other four were born with serious low weight problems. In mid-December there was an increase, she says, in the cases of morbidity in babies and the number of patients in neonatology increased. Among the newborns in the low-weight cubicle, one died of sepsis, which made it possible to identify the other deaths linked to this fact.
Among the newborns in the low-weight cubicle, one died of sepsis, which made it possible to identify the other deaths linked to this fact
According to the doctor, the event was limited to that cubicle, one of the four in neonatology – divided into an intensive care unit, an intermediate cubicle, a low-weight cubicle and a pathological cubicle – and the four patients remaining in it have been isolated and they evolve favorably. The rest of the rooms are independent and there has not been, she explains, any similar case. She also cites some measures taken in this regard, such as the reinforcement of doctors and one nurse per child.
The specialist recalls that there is a shortage of medicines, but insists that for this case the troops have been concentrated, “including colistin, a last-generation antibiotic used for gram-negative bacteria.”
The remaining four babies died due to the high risks of dying that affect premature infants (80% of newborn deaths in the world are due to this cause, according to Unicef), as in the case of one, which specifically details that he was born at 29 weeks and with just 1,100 grams. Others had even been in intensive care for 20 days.
The reason why the sepsis case occurred is still being investigated, although the doctor recalls that intensive care patients are more prone to infections, and gives the example of bronchopneumonia linked to assisted ventilation.
Having clarified these details, the report focuses on the reasons that are leading to an increasing rate of prematurity and, in parallel, infant mortality. The doctor affirms that the issue is much more complex than it seems and that not only deficiencies have an influence, but other factors, including the increase in adolescent pregnancies – more than 17% of births correspond to women under 20 years of age. in Cuba–, which entail more risks of this type, and changes in lifestyles, which have increased the number of chronic diseases among women. Among the latter, she cites the rise in cases of diabetes and hypertension, and the prevalence of obesity.
“Prematurity in Havana is associated, above all, with an important risk factor: arterial hypertension in pregnant women, or that which develops during pregnancy,” says Rodríguez Espinosa, who cites genetics and diet as main factors. to suffer it.
Fernando Domínguez Dieppa, from the Ramón González Coro Gynecobstetric Teaching Hospital and author of studies on prematurity, affirms that the quality of care during pregnancy is decisive in prematurity, since it can help to prevent it, but there are also many other cases in those that are difficult, such as multiple births or a history of preeclampsia (a syndrome characterized by the presence of hypertension, edema, and excess protein in the urine).
The specialist maintains that more than 90% of extremely premature babies born in poor countries die in the first days of life, while in the rich the number falls to less than 10%.
The specialist maintains that more than 90% of extremely premature babies born in poor countries die in the first days of life, while in the rich the number falls to less than 10%. In Havana, he points out, the survival rate is 95%. The data, if true, is better than that of countries like the US (8%) or the United Kingdom (7%), but double that of Sweden (2.5%) and much more than Spain or Portugal, where they barely exceed the 1%.
The Ministry of Health admits that there are all kinds of problems in the Maternal and Child Program (Pami), including the increase in low weight in newborns, the lack of medicines, errors in prenatal diagnoses, non-compliance with sanitary and hygienic regulations, etc. . However, it does not address the causes that, according to some doctors who have been part of it, are the decapitalization of the program and, in general, of the entire sector, which many professionals end up abandoning due to lack of means, low salaries and high demands.
The results are a growing infant mortality that last year it was 7.5 per thousand, just one tenth less than in 2021 (7.6), but more than two and a half points above 2020, when it was 4.9. Although the Island still maintains relatively good figures in the regional context, the days in which it could be compared with some health systems of first world countries are running out.
________________________
Collaborate with our work:
The team of 14ymedio He is committed to doing serious journalism that reflects the reality of deep Cuba. Thank you for accompanying us on this long road. We invite you to continue supporting us, but this time becoming a member of our newspaper. Together we can continue transforming journalism in Cuba.
