Eminyakeni emibili eyedlule e-United States, ingane eyodwa kwabangu-10 yazalwa ngaphambi kwesikhathi , noma ngaphambi kwamasonto angu-37 okukhulelwa. Kusukela kuleso sibalo samuva, kuye kwaba nokucindezela okubalulekile ukuzama ukunciphisa amazinga okushisa kokuqala e-US, kodwa i-CDC ibhala ukuthi kuze kube manje, kusencane kakhulu ukutshela ukuthi imizamo yethu isisebenzise-noma uma inani le-prematurity uzoqhubeka kuphela ukuphakama.
Izinsana ezizalwa ngaphambi kwesikhathi zisengozini enkulu yokubhekana nemiphumela emibi yempilo nezimo ngemuva kokuzalwa. Uma ingane ingakafiki isikhathi eside, iphakama amathuba okuba bangabhekana nezinkinga. Uma umntwana ozelwe ngaphambi kwesikhathi adinga ukunakekelwa okwedlulele nokunakekelwa okwengeziwe, cishe uzovunyelwa ekamelweni lokunakekelwa kwezingane ezincane noma iNICU . Ukuhlala ku-NICU kuzohluka ngokuya kwesimo somntwana nezidingo zezempilo, kodwa into eyodwa iqinisekile: Abantwana ku-NICU badinga lonke usizo nokunakekelwa kwezempilo abangayithola.
Futhi ngeshwa, idatha entsha yembule ukuthi akuzona zonke izingane eNICU ezithola inani elifanayo lokunakekelwa nokunakekelwa kwabasebenzi bezokwelapha. Isizathu? Umjaho. Umbiko omusha we-American Academy of Pediatrics uye wembula ukuthi kukhona ukungalingani kobuhlanga ekunakekeleni ngaphakathi kwe-NICU. Kusho ukuthini lokho? Kusho ukuthi abantwana abamhlophe bathola ukunakekelwa okungaphezulu nokunakekelwa kwezempilo kusuka kwabasebenzi kanye nochwepheshe, kanti izinsana ezingekho abamhlophe zithola ukunakekelwa okungezansi kwezempilo.
Leli qiniso liyakhathazeka ikakhulukazi uma ucabanga ukuthi izinga lokubeletha ngaphambi kokuqala lilinganiselwa kwesigamu esiphezulu kwabesifazane abamnyama kunabesifazane abamhlophe. Lokho kusho ukuthi kukhona iphesenti ephakeme yabantwana abamnyama abazalwa ngaphambi kwesikhathi futhi kuzodinga ukunakekelwa okungaphezulu ukuze baqale empilweni. Kodwa hhayi kuphela abantwana abantsundu abazalwa ngaphambi kwesikhathi, futhi bayaqhubeka nokuthola ukunakekelwa okwanele kwezokwelapha ku-NICU.
Lokhu kuthinta kabili impilo nempilo yabo.
Ucwaningo
Ucwaningo olwenziwe ngo-Agasti 2017 lwe- Pediatrics , lwabheka izinsana eziyi-18,616 ezisezingeni eliphansi kakhulu zokubeletha (ezihlukanisiwe njengezingane ezinesisindo esingaphansi kuka-1,500 amagremu ngesikhathi sokuzalwa). Esinye sezici ezikhomba ukuthi ukunakekelwa kwengane okudinga ukubeletha kubaluleke kangakanani ekuzalweni ukuthi ngabe uyalinganisa kangakanani, ngakho-ke lolu cwaningo lufakwe ezinganeni ezibeletha kakhulu kakhulu ngoba cishe zidinga ukukhathazeka kakhulu. Ukuyibeka ngendlela efanele, amagremu angu-1,500 angaphezu kwamakhilogremu amathathu, kanti isanazane esiphelele esigcwele esilingana nesisindo singaphezu kwamakhilogremu angu-7. Iphoyinti? Lezi zingane ezincane zazifundiswa.
Ucwaningo luhlolisise ukunakekelwa kwalezi zinsana, ezathinteka kuma-NICU angu-134 kulo lonke elaseCalifornia phakathi kuka-2010 no-2014, ngaphezu kweminyaka emine. Abacwaningi basebenzisa isilinganiso esikhethekile ngezinkomba eziyi-9 zekhwalithi ezibizwa ngokuthi i-Baby-MONITOR esetshenziselwa ukubeka uhlobo lokunakekela izingane ezithola ku-NICU. Bathole ukuthi izingane ezingenalo iSpanishi ezimhlophe zazihola ngaphezulu ngezinyathelo zenqubo ngesilinganiso uma kuqhathaniswa nabantwana abamnyama nabaseSpanishi. Abantfwana abantsundu bahola ngaphezulu kwezilinganiso zomphumela uma kuqhathaniswa nezingane ezimhlophe kanye ne-Hispanics bahola phansi kunazo zonke ezingaphansi kwamaphesenti angu-9 angama-9.
Ngokucacile, abacwaningi bathola ukuthi izingane eziningi zaseNigeria nezomnyama zazalwa eminyakeni yobudala obukhulu kakhulu kunamazinyane ezimhlophe nokuthi izingane eziningi ezimnyama zazalwa ezinamazinga aphansi e-Apgar.
Izinsana zaseSpanishi zenzeka kakhulu kunoma yiziphi amaqembu ezinsana zokudinga ukudluliselwa esikhungweni esiphakeme seNICU ngemuva kokuzalwa. Uma kuqhathaniswa nezinsana ezimhlophe, izingane ezincane abamnyama nabaseSpanishi babengenakuthola amathuba okuthola usizo oluthile lwezokwelapha, njenge-steroid therapy, izivivinyo zamehlo, ngisho nokudla ubisi lwebele . Bobabili amaqembu ezinsana ababengabamhlophe nawo angase abe nokutheleleka esibhedlela. Kwakukhona, kodwa, imiphumela emibili yezempilo ukuthi izinsana ezimnyama zinezibalo eziphakeme kakhulu: Babencane amathuba okuthola iphaphu eliphelile, futhi babe namanani okukhula okungcono, futhi.
Ukutholakala kwaveza nokuthi ukuhlukana kokunakekelwa kwakungeyona yonke indawo; kwezinye izibhedlela ezinezinsizakalo ezisezingeni eliphansi, abantwana abantsundu empeleni baphumelela kangcono kunabantwana abamhlophe.
Babengaqiniseki ukuthi kungani ezinye izibhedlela zembula izilinganiso ezihlukene, kodwa ngokuvamile, abantwana baseSpain, abalandelwe abantwana abantsundu babonakala behle kakhulu kunabantwana abamhlophe ku-NICUs. Abacwaningi bathola ukuthi jikelele, kwakukhona izingane eziningi ezazingabantu baseSpanishi nabamnyama abaphathwa nge-NICU ephansi, okungase kuchaze okungafani. Kodwa ngisho naku-NICU ephezulu, ukungafani bekukhona.
Ngokubanzi, lo mbiko wachaza ukuthi ukungafani kobuhlanga ekunakekelweni esibhedlela sekukhona isikhathi eside futhi kuye kwaba umgomo ochwepheshe bezokwelapha ukunciphisa ukungalingani. Ngisho nakuhlelo lwe-NICU, kunezinkinga ezimbili eziyinhloko ezingase zenzeke: 1) Abantfwana abamnyama nabaseSpanishi abatholi ukunakekelwa okusezingeni eliphezulu esibhedlela futhi 2) Abantwana abamnyama nabaseSpanishi banamathuba amaningi okuhlala eNICU ephansi , okusho ukufinyeleleka okuncane ezinsizeni zezokwelapha kanye nabasebenzi abaphezulu nabasebenzi. Nakuba odokotela kanye nochwepheshe bezokwelapha abaqiniseki ngokuphelele ukuthi bangayilungisa kanjani le nkinga okwamanje, beqaphela ukuthi inkinga ikhona ekuqaleni kuqala isinyathelo esibalulekile sokuqala.
Okutholakele
Ucwaningo luphetha ngokuthi akukhona nje umehluko ekunakekelweni kwezokwelapha okusekelwe eziciwaneni zobandlululo noma / noma zobuzwe, kodwa ukungalingani kuyinto enkulu. "Ukuhluka okubonakalayo ngokohlanga ngokobuzwe / / noma ngokobuhlanga phakathi kweNICU kanye naphakathi kwama-NICU," abalobi babhala kulolu cwaningo.
Izinto ezibangela ukungalingani ngokobuzwe zijulile futhi zihlangene futhi "hhayi nje isikhumba-esijulile," okwenza kube nzima nakakhulu ukuzilungisa. Isibonelo, abantwana abantsundu bangase babelethwe ezindaweni ezingabanjwanga kahle, okusho ukuthi bangaphathwa esibhedlela ngezimali eziphansi noma abasebenzi abakhokhelwayo noma abazali babo bangase babhekane nezinselele zempilo ezinjengezidakamizwa noma ezinye izifo okuvimbela ukunakekelwa okufanele kokubeletha . Inkinga ayiyona nje elula njengokuqaphela ukuthi kunokungafani kobuhlanga ekunakekelweni kwezokwelapha kodwa ukwehlisa zonke izici ezingena kulokho ukungalingani ukuzama ukuxazulula.
I-Takeaway
Njengoba kunzima ukuthi ubhekane nemiphumela yalolu cwaningo, lunikeza ukubuka okuqondisisa ukuthi ukungalingani ngokobuhlanga kungathinta kanjani ukunakekelwa kwezokwelapha, ngisho nasezingeni le-NICU. Ngisho nomncane kunazo zonke futhi osengozini kakhulu yeziguli, izinsana ezingakafiki, zithola ukunakekelwa okungaphansi kwezempilo uma isikhumba sabo sinobumnyama kunamantombazane angaphambi kwesikhathi. Njengomzali noma umnakekeli, kubalulekile ukuqaphela lesi sibalo esicasulayo ukuze sikwazi ukwenza njengommeli wezempilo wezingane zethu ngempumelelo. Kukhona amandla olwazini, noma ngabe yiqiniso esifisa ukuthi asikaze sikubone kuqala. Kubalulekile ukuba ngummeli wempilo yengane yakho futhi uqaphele ezinye zezinselele ezikhona ohlelweni lwezokwelapha olungabangela ingozi empilweni yomntanakho, kubandakanya ukungalingani ngokobuhlanga ekunakekeleni.
> Imithombo:
> CDC. Ukuzalwa kwangaphambi kwesikhathi. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm
> Jochen Inzuzo, uJeffrey B. Gould, uMihoko Bennett, uBenjamin A. Goldstein, DavidDraper, uCyaran S. Phibbs, uHenry C. Lee (2017, Agasti). Ukungafani ngokobuzwe / ngokobuzwe eNicU Quality of Delivery Care. Izingane zokwelapha . e20170918; I-DOI: 10.1542 / ama-peds.2017-0918