Addressing Critical Knowledge Gaps in Newborn Health

Born Too Soon: 5 points for action on preterm birth

The following post was written by Joy Lawn, Mary Kinney and Christopher Howson, co-editors of Born Too Soon: The Global Action Report on Preterm Birth. It is the first post of an HNN Blog Series that will lead to World Prematurity Day on November 17 discussing preterm birth and highlighting the actions needed to prevent and reduce preterm birth, the leading cause of newborn deaths. Join us as we discover that everyone has a role to play.

Born Too Soon: The Global Action Report on Preterm Birth released this week, carries a foreward by Ban Ki Moon, the UN Secretary general, and brought together more than 100 experts representing almost 50 agencies, universities, organizations, and parent groups. This report highlights the first ever country estimates of preterm birth rates and identifies solutions for prevention of preterm births and to save the lives of premature babies. The 40 logos on the report are a clear signal of increasing global attention.

Prematurity is now is the second-leading cause of death in children under the age of 5 after pneumonia. Global progress for child survival and health to 2015 and beyond cannot be achieved without addressing preterm birth. Yet prematurity is also a huge burden in rich countries. Born Too Soon is an ACTION report and removes any excuse for missing the enormity of the problem, and sets out actions to take. We all have a role to play.

5 headline messages:

  1. 15 million babies are born too soon every year
  2. Preterm birth rates are rising
  3. Prevention of preterm birth must be accelerated
  4. Premature babies can be saved now with feasible, cost-effective care
  5. Everyone has a role to play

15 million babies are born too soon every year

Based on the first ever national estimates of preterm birth for 184 countries, in the year 2010, more than 1 out of 10 babies are born too soon, an estimated 15 million preterm (or babies born before 37 weeks of gestation). More than one million of those babies die shortly after birth and many of those who survive will face lifelong physical, neurological, or educational disability, at great cost to families and society.

Preterm birth affects families all around the world. Over 60% occur in Africa and Southern Asia, but high rates are also seen in some high-income countries, such as the United States, where 500,000 preterm babies are born each year. Behind every statistic is a personal story. For some it is a story of survival, for many it is survival sometime with the reality of a lifelong disability and sadly for some it is a story of loss.

Preterm birth rates are rising

Of the 65 countries with time trends estimates 1990-2010, only 3 countries have shown a reduction in preterm birth rates.

Prevention of preterm birth must be accelerated

Reducing preterm birth rates involves reducing risks before and during pregnancy and at birth. Family planning, identification and treatment of infections, as well as prevention of malaria, all hold promise, especially in low-income settings. In high-income settings, these risks are less common and increasing rates are linked to older women having babies, increased use of fertility drugs and the resulting multiple pregnancies; also to increasing caesarean sections that are not always medically indicated, as well as lifestyle challenges such as obesity, smoking and diabetes. Often no cause is identified. Vigorous and strategic investment in research is needed to identify new solutions.

Premature babies can be saved now with feasible, cost-effective care

Historical data, new lives saved modelling analyses and experience in middle-income countries show that an estimated 75% of preterm baby deaths could be prevented without neonatal intensive care. But the most startling gap highlighted in the report is the survival gap for preterm babies depending on where they are born. In low-income countries, more than 90 percent of extremely preterm babies (younger than 28 weeks or more than 3 months early) die within the first few days of life, while less than 10 percent die in high-income countries.

This 90:10 survival gap means these babies are not just born too soon – they are born to die, with even their families not knowing there are highly effective solutions that could save their lives. Kangaroo Mother Care and antenatal corticosteroids have the highest impact on saving the lives of premature babies. If universally available, antenatal steroid injections for mothers in premature labor could save almost 400,000 lives of babies a year, and Kangaroo Mother Care could save another 450,000 lives each year. Urgent action is needed to close this gap.

"The 90/10 survival gap between high and low income countries is one of the most shocking statistics in Born Too Soon."

Everyone has a role to play

The momentum behind this report has led to the first ever globally agreed upon goal to halve the number of babies dying from preterm birth by 2025. This can be achieved but requires preterm birth to receive attention around the world, policymakers to invest and implement and the voice of affected parents to be heard.

This report has shocking new data and moving personal stories of loss. Yet it is also a story of hope in the significant opportunities for change, especially as we approach the final sprint for the MDG 4 target and aim to maintain momentum beyond 2015. Over 30 organizations have given specific commitments to preterm birth to Every Woman Every Child, and will be held accountable by this framework. Everyone has a role to play and together we can make each statistic, each story count for change. How can you support your family and friends who are affected? Do you have a story to tell? A commitment to make? What will you do?

As the three editors of this report and on behalf of the many involved in Born Too Soon, we throw out a challenge that by World Prematurity Day on November 17 2012, policymakers, professionals and parents all over the world will see this important challenge of preterm birth and that together we will have clear plans for real change for the 15 million babies born too soon and their families.

“ All newborns are vulnerable, but preterm babies are acutely so” -- Ban Ki Moon, Foreward to Born too Soon.

Learn More:

Complete Blog Series on preterm birth: