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World Prematurity Day (WPD) is held on 17 November annually to raise awareness of preterm births. According to the World Health Organization, every year, an estimated 15 million babies are born preterm. Preterm birth complications are the leading cause of death for children under five, causing an estimated one million deaths in 2015 globally.

WPD honours the premature babies who have fought hard to survive and remembers those babies for whom the struggle was too great. The colour purple has become synonymous with WPD and awareness activities include wearing pins, morning teas, dressing up in purple, and sharing stories via social media.

According to Mater Mothers’ Hospital Neocritical Care Unit Associate Professor Luke Jardine, changes to the way premature babies are treated in the delivery room has led to marked improvements in survival rates as well as a decline in lung disease amongst newborns who arrive before full term.

He says resuscitating premature babies immediately after birth by using a device that delivers airway pressure through a small mask over their noses has reduced the need to insert breathing tubes into the tiny newborns.

“Using Continuous Positive Airway Pressure (CPAP) devices has led to a 20% reduction in the number of babies needing a breathing tube and a ventilator immediately after birth,” Professor Jardine said.

“This may result in an increase in these extremely premature babies surviving without lung disease.”

Associate Professor Jardine said the unit is also looking at the way premature babies are administered surfactant, a drug used to treat the lung disease of prematurity.

“Instead of inserting it via a breathing tube which is the way it has traditionally been done, we are now leaving the baby on CPAP and using a small catheter to administer it,” he said.

Associate Professor Jardine says World Prematurity Day provides an opportunity to reflect on the advances in technology and treatments for premature babies in recent decades.

“The Neonatal Critical Care Unit is working very hard to not only improve survival of our preterm infants but to also decrease the complications of being born preterm,” he said.

“Apart from decreasing the use of breathing tubes, we also have projects aimed at stopping babies getting cold after delivery, preventing infections and reducing severe bleeding into the brain.

“We are also increasing the amount of time babies have skin to skin contact with their parents, and minimising the amount of handling that babies receive in the first few hours of life.”

To mark World Prematurity Day, experts at RMIT have also shared how their research is helping to improve the lives of babies born too soon and their families. Early birth can be damaging in many ways, disrupting the growth of the baby’s vital organs that would usually occur during the final stages of pregnancy, experts say. Besides losing the support of the placenta, which produces growth factors to help the infant develop, the gut of the preterm baby isn’t ready to absorb nutrients to help them grow fully.

Even the lights and noises of the outside world can disrupt brain development and leave a lasting impact on a person’s ability to read, communicate, concentrate, or interact in social settings.

Preterm birth increases the likelihood of lifelong changes in growth and development, such as cerebral palsy, impaired cognitive function, and autism spectrum disorder.

RMIT’s Neurodevelopment in Health and Disease research program focuses on healthy brain development and the early origins of neurological disease.

“Many of us are investigating health issues relevant to children born too soon, related either to risk factors linked to preterm birth or to long-term health issues resulting from it,” said Professor David Walker, Program Leader.  

The RMIT team is participating in PREMSTEM, an international research and innovation program funded by the European Union’s Horizon 2020 scheme.

Using stem cells from donated umbilical cord tissue, the international team is aiming to develop a new treatment for brain damage associated with preterm birth, known as encephalopathy of prematurity.

“We know that stem cells help to regenerate and rebuild damage to our body under the right conditions, with previous studies showing that they can play a part in repairing perinatal brain injury,” Professor Walker said.

“We want to find the best way to unleash this potential – to determine the right moment to give the stem cells, the best way to deliver them into the body, and the correct dosage.”

Fetal growth restriction (FGR) occurs when a problem within the placenta stops the baby from growing properly during pregnancy, often leading to preterm delivery and a risk of abnormal brain development.  

Associate Professor Mary Tolcos’ research group is studying the therapeutic potential of a thyroid hormone compound, DITPA, in preclinical models of FGR.

With funding from the NHMRC and Cerebral Palsy Alliance Research Foundation, they are testing whether DITPA can prevent abnormal brain development and injury when given either before birth (to the mum) or after birth (to the baby).

“It’s promising to see an enhanced development of myelin – the fatty insulation around nerve fibres – when we give DITPA for a short period of time in our FGR model after birth,” Professor Tolcos said.

“We’re now investigating whether DITPA can prevent other forms of brain injury if given for longer, and if these positive effects continue into adolescence.”

Associate Professor Elisa Hill-Yardin’s research group is conducting preclinical research on the gut-brain axis and how it relates to neurodevelopmental disorders like autism, a risk for children born preterm. 

Professor Sarah Spencer and her team are looking at why diet before and during pregnancy matters.

A particular focus is the link between unhealthy diets and inflammation in the central nervous system, which can weaken brain function in both mother and baby.

As well as nourishing a baby during pregnancy, the placenta plays a key role in the development of pregnancy complications such as preeclampsia, affecting some expectant mothers and causing preterm birth, experts say.

To find out more about World Prematurity Day visit