Premature birth – giving birth before the 37th week of pregnancy – is one of the factors that is preventing progress in improving the health and survival of children, according to the report ‘Born too soon: a decade of action on premature birth’, prepared by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in collaboration with PMNCH, the world’s largest alliance for women, children and adolescents.
The document reveals that between 2010 and 2020, 152 million premature babies were born, and that the rates of premature births have not changed in any country in the last decade, according to updated estimates by the WHO and UNICEF, carried out with the School of Hygiene and Medicine. Hospital of London, which indicate that in 2020 13.4 million children were born prematurely -which means that around one in 10 babies were born prematurely-, of whom almost a million died due to complications associated with the prematurity.
These agencies consider premature birth a “silent emergency” because it is the leading cause of infant death, accounting for more than 1 in 5 of all deaths in children under the age of five. In addition, surviving premature babies may have health problems throughout their lives and are more likely to experience developmental delays and disability.
Factors that determine the survival of premature babies
The new report builds on another on the same subject published in 2012 and offers a comprehensive overview of the prevalence of preterm birth and its severe effects on women, families, societies and economies. It is very common that the survival of premature babies is determined by their place of birth, since the report reveals that only one in 10 extremely premature babies (born before the 28th week of pregnancy) survive in low-income countries, in compared to more than nine in 10 in high-income countries. Yet even in wealthy nations, the odds of premature birth, death, and disability are directly related to the vast inequalities associated with race, ethnicity, income, and access to quality health care.
“The devastating combination of COVID-19, climate change, expanding conflict and rising cost of living has worsened maternal and newborn health”
The highest rates of preterm birth and the highest risk of mortality are in South Asia and sub-Saharan Africa; Together, these two regions account for more than 65% of preterm births globally. The authors of the report have also highlighted that the consequences of conflict, climate change and environmental damage, COVID-19 and the rising cost of living increase the risks for women and babies everywhere. For example, it is estimated that air pollution contributes to 6 million premature births each year. Nearly 1 in 10 babies are born prematurely in the 10 most fragile countries affected by humanitarian crises, according to a new analysis of the report.
Adolescent pregnancy and preeclampsia, among other risks to maternal health, are closely related to preterm births, highlighting the need to guarantee access for all women to sexual and reproductive health services, including planning family and high-quality care throughout pregnancy and delivery. In fact, the WHO has warned that every seven seconds a woman or baby dies in the world from causes that are preventable or treatable with adequate health care, which represents a total of more than 4.5 million deaths per year that could be have avoided.
Measures to improve care for mothers and newborns
In light of the alarming findings in the report, WHO, UNICEF, UNFPA and PMNCH have called for the following strategies to improve care for women and newborns and reduce the risks of preterm birth:
- Increased Investments: Put in place the leveraging of national and international resources to optimize maternal and newborn health and ensure that high-quality care is provided when and where it is needed.
- Accelerated Implementation: Meeting the country’s progress goals through the implementation of established national policies for maternal and newborn care.
- Integration between sectors: promote education in all stages of life; support smarter economic investments, with co-financing in all sectors; enhance climate adaptation responses throughout the life cycle and advance in the coordination and resilience of emergency systems.
- Locally Driven Innovation: Invest in locally led innovation and research to support improvements in quality of care and facilitate equal access.
“This new report shows that the cost of inaction over the past decade was 152 million babies born prematurely. While some regions are more affected, preterm birth threatens health progress in all countries. Greater investment in the care of vulnerable newborns can save millions of families from heartbreak. More work is also needed to prevent preterm births, which will also enhance progress in reducing stillbirths and maternal deaths. Together, these twin pathways of prevention and care of preterm infants will produce healthier individuals and societies for economic and social development. The next generation depends on us all acting now: the investment may not be small, but the benefits of this investment will be significant for all countries,” said Professor Joy Lawn, Co-Director of the London School of Hygiene and Tropical Medicine,
For his part, Dr. Anshu Banerjee, WHO Director of Maternal, Newborn, Child and Adolescent Health and Aging, highlights: “Ensuring quality care for these smallest and most vulnerable babies and their families it is absolutely imperative to improve child health and survival. Progress is also needed to help prevent preterm birth; this means that all women must be able to access quality health services before and during pregnancy to identify and manage risks”.
“Being born too soon underscores why we must increase investment in and responsibility for premature birth, the world’s leading cause of death for children under five. Progress is stalling for maternal and newborn health, as well as for the prevention of stillbirth, and has now been further set back by the devastating combination of COVID-19, climate change, expanding conflict and the rising cost of living”, said Helga Fogstad, Executive Director of PMNCH.
“By working together in partnership – governments, donors, the private sector, civil society, parents and health professionals – we can sound the alarm about this ‘silent emergency’ and bring prevention and early care efforts to the forefront of national health and development efforts, building human capital supporting families, societies and economies everywhere”, he concludes.
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