New UN-backed report calls for action to prevent millions of preterm births
“All newborns are vulnerable, but preterm babies are acutely so,” says Secretary General Ban Ki-moon, who wrote the foreword to the report, entitled Born Too Soon: The Global Action Report on Preterm Birth.
The report points out that more than one million preterm babies die shortly after birth, while countless others suffer some type of lifelong physical, neurological, or educational disability, often at great cost to families and society.
It adds that an estimated three quarters of the preterm babies who die could survive without expensive care if a few proven and inexpensive treatments and preventions were available worldwide.
“Being born too soon is an unrecognized killer,” says the co-editor of the report and Director of Global Evidence and Policy for Save the Children, Joy Lawn. “Preterm births account for almost half of all newborn deaths worldwide and are now the second leading cause of death in children under five, after pneumonia.”
The report was produced by The March of Dimes Foundation, The Partnership for Maternal, Newborn & Child Health, Save the Children and the World Health Organization (WHO), with contributions from over 100 experts, representing almost 40 UN agencies, universities and organizations.
WHO’s Assistant Director-General Flavia Bustreo told a news conference at UN Headquarters in New York that the report shines a light on one of the challenges that is critical for making progress on women’s and children’s health, namely addressing that moment around the time of delivery where extreme vulnerability exists both for the mothers and for the newborns. “But a special vulnerability exists for the babies that are born too soon,” she noted.
The report contains new figures showing the magnitude of the problem and the disparities between countries. Of the 11 countries with preterm birth rates over 15 per cent, all but two are in sub-Saharan Africa.
Preterm births account for 11.1 per cent of the world’s live births, 60 per cent of them in South Asia and sub-Saharan Africa. In the poorest countries, on average, 12 per cent of babies are born too soon, compared to nine per cent in higher-income countries.
The problem of preterm births is not confined to low-income countries, according to the report. The United States and Brazil both rank among the top ten countries with the highest number of preterm births. In the US, for example, about 12 per cent – or more than one in nine of all births – are preterm.
The countries with the greatest numbers of preterm births are India (3,519,100), China (1,172,300), Nigeria (773,600), Pakistan (748,100), Indonesia (675,700), US (517,400), Bangladesh (424,100), Philippines (348,900), the Democratic Republic of the Congo (341,400), and Brazil (279,300). Those with the lowest rates of preterm births include Belarus, Ecuador, Latvia, Finland, Croatia, and Samoa.
In high-income countries, the increases in the number of preterm births are linked to the number of older women having babies, increased use of fertility drugs and resulting multiple pregnancies. Medically unnecessary inductions and Caesarean deliveries before full-term are also factors.
In many low-income countries, the main causes of preterm births include infections, malaria, HIV, and high adolescent pregnancy rates.
WHO’s Director of Maternal, Newborn, Child and Adolescent Health, Elizabeth Mason, noted that a key way to reduce preterm births is to find ways to help all pregnancies go to full term, or 39 weeks.
“We are now looking closely at what can be done before a woman gets pregnant to help her have an optimal outcome,” said Dr. Mason, adding that poverty, women’s education, malaria and HIV all have an impact on the pregnancy and the health of the baby.
Born Too Soon: The Global Action Report on Preterm Birth recommends addressing the issue of missing essential medicines and equipment, training existing health staff in how to look after women in preterm labour and these vulnerable babies, increased funding for research to find new prevention solutions, and better data for accurate future counts.
It also offers an agenda and action plan for all groups concerned with preterm birth and child health, ranging from the UN and governments at all levels to donor countries to global philanthropic institutions and civil society.