Beware of these 10 types of people giving birth to "premature babies"! Obstetrics and Gynecology Expert: "Three Major Pregnancy Concepts" You Must Understand Before Pregnancy
The problem of low birthrate in Taiwan is becoming increasingly serious, and the premature birth rate remains high. According to statistics, 1 in 10 newborns is a premature baby born alive at less than 37 weeks, and the incidence rate is even higher than the global and Asian averages. Preterm birth is also considered the leading cause of death in children under 5 years old. Zhan Defu, chairman of the Taiwan Society of Perinatology, expressed concern that although most people in Taiwan are aware of tocolysis, they have insufficient awareness of the safety risks of tocolysis treatment, and there is room for optimization of clinical first-line treatments.
One out of every three people in Taiwan will give birth at an advanced age. Late marriage and late childbearing will lead generations to be wary of the crisis of premature birth.
Modern people are more likely to marry late and have children late. The average age of women giving birth in 2023 is 32.44 years old, and pregnancy over the age of 34 is considered an advanced maternal age. Starting from 2021, 1 in every 3 pregnant women in Taiwan will give birth to a child of advanced age every year. Domestic and foreign studies have pointed out that 1 in 6 pregnant women of advanced age will suffer from gestational diabetes; 10% of pregnant women will suffer from various hypertension disorders during pregnancy.
Chairman Zhan Defu pointed out that the cardiopulmonary pressure of pregnant women is already greater than that of non-pregnant women. If older women or pregnant women with complications during pregnancy face the risk of premature birth and related treatments, related safety issues require urgent attention from all walks of life. As for the definition of preterm birth, it refers to a birth that is more than 20 weeks of pregnancy but less than 37 weeks, which can be subdivided into spontaneous, water rupture and iatrogenic preterm birth.
Among them, the main cause of iatrogenic premature birth is the physical condition of pregnant women, such as pre-epilepsy, gestational diabetes, kidney disease, advanced age, and multiple births. In recent years, the proportion of iatrogen-induced premature births has been increasing year by year. Secretary-General Huang Jianpei of the Taiwan Obstetrics and Gynecology Association reminded that once signs of premature birth or early-onset uterine contractions appear during pregnancy, tocolysis treatment should be carried out carefully to extend the pregnancy weeks and allow the pregnancy to be prolonged. The fetus stays in the mother’s womb to develop and mature, which helps to improve the survival rate and reduce the occurrence of serious complications, mortality and sequelae of premature birth.
Do taking anti-fetal drugs have serious side effects? Experts are shocked to reveal that more than 70% of patients suffer from “tachycardia”
Chairman Zhan Defu explained that there are currently two therapeutic drugs approved by the Taiwan Ministry of Health and Welfare for preventing and delaying premature birth (tocolysis). One of them is “β-agonists”, whose ingredients are Sympathetic stimulants similar to clenbuterol can inhibit the contraction and intensity of the uterus. However, this drug also acts on the bronchi and blood vessels, resulting in a high incidence of side effects.
Clinical studies have pointed out that after using beta-receptor agonists, about 75.5% of pregnant women will experience tachycardia, and about 15.6% will experience discomfort such as palpitations, chest tightness, chest pain, dizziness, general weakness, and dyspnea, which may also occur. Fatal acute pulmonary edema. Chairman Huang Jianpei added that the association will issue announcements in 2020, proposing precautions for the careful use of this type of drugs to avoid the risk of complications and life-threatening consequences.
Chairman Xiao Shengwen said that if pregnant women belong to high-risk groups such as advanced age, pre-pregnancy obesity, thyroid abnormalities and pregnancy-related diseases, the use of beta-receptor agonists may cause more harm than good. Moreover, this type of drug was banned by the European Union as early as 2013, and its use is not recommended in European countries such as the United Kingdom. The United States even recommended reducing the use of this drug due to the high incidence of side effects. It is obvious that European and American countries have long realized the importance of safe use of tocolytic drugs. sex.
Fortunately, the second type of tocolytic drug, “oxytocin receptor antagonist”, has been included in health insurance benefits in recent years. It only targets oxytocin receptors and has high specificity in accurately inhibiting uterine contractions. Clinical studies have shown that it has cardiovascular benefits. The incidence of effects is only about 8.3%, the incidence of serious side effects is low, and it is well tolerated, which can better ensure the safety of pregnant women’s tocolysis at the same time.
“Top 10 ethnic groups” most likely to give birth to premature babies! Seize the golden 48 hours for safe tire management
In order to enhance the understanding of tocolysis treatment to prevent premature birth, and to provide pregnant women with a safe and secure tocolysis treatment environment, three major obstetrics and gynecology-related medical societies jointly released the “Top 3 Tocolysis Treatment Recommendations”, hoping to arouse the awareness of tocolysis safety in both mother and fetus. Attention:
Suggestion 1: The concept of tocolysis treatment “medicine” should be in line with international standards.
The World Health Organization’s recommendations on preterm birth point out that oxytocin receptor antagonists are the best among all types of tocolytic drugs in helping to delay pregnancy in cases of premature birth less than 28 weeks; many European countries have even recommended the priority use of oxytocin receptor antagonists in the first line. body antagonist. In view of this, we encourage Taiwan’s frontline clinical applications to raise standards and align with international treatment trends to create a mother-child-friendly environment.
Recommendation 2: Pay attention to the top ten high-risk “medicines” for pregnant women.
The top ten high-risk groups of pregnant women should pay more attention and caution when it comes to the safety of tocolysis treatment, including elderly pregnant women, pregnant with multiples, those with high blood pressure and cardiovascular disease before or during pregnancy, diabetes or gestational diabetes, thyroid dysfunction, Abnormal lung function or asthma, abnormal renal function, autoimmune diseases, pre-pregnancy obesity (BMI ≥ 30), electrolyte imbalance, etc. The above-mentioned groups should proactively consult a doctor.
Recommendation 3: Seize the golden 48 hours for safe miscarriage.
The purpose of inpatient tocolysis treatment is to give drugs for at least 48 hours to promote fetal alveolar maturation and reduce the occurrence of neonatal respiratory distress syndrome in premature infants. It will also help the fetus’ breathing after birth, reduce complications and increase survival. Rate. There are now safer oxytocin receptor antagonists available for payment. If they meet the indications, pregnant women in high-risk groups can receive an effective and safe treatment model on the first line.
The cost of medical treatment for premature babies is 10 times higher than that for full-term babies! Expectant parents should thoroughly understand the correct concept of fetal safety
With late marriage, late childbearing, and low fertility rates, fetal survival is even more precious. Secretary-General Huang Jianpei reminded that it is not easy for pregnant women with advanced age and complications during pregnancy to give birth, and pregnant women and fetuses should not be exposed to more risks during pregnancy. In addition, premature birth will also bring huge care and financial pressure to the entire family; according to statistics, the medical expenses of premature infants are more than 10 times that of full-term infants, and even the mortality rate before 1 year old will be relatively higher.
Chairman Zhan Defu called on obstetricians to work together to reduce risks such as side effects of tocolysis; Chairman Xiao Shengwen also suggested that pregnant women and their partners should be aware of possible risks during pregnancy and actively understand the concept and risks of tocolysis. Regarding drug safety, especially pregnant women who fall into the top ten high-risk groups should understand the latest tocolysis treatment concepts as soon as possible and be fully prepared for the health of their fetus and themselves.
