Conversations on World Prematurity Day

Nov 17 is World Prematurity Day. This day is about raising awareness, advancing research, promoting advocacy, education, and action to reduce the burden of premature birth at global, regional and national levels. Born too Soon was published in 2012, jointly by March of Dimes, Partnership for Maternal Newborn and Child Health, Save the Children, and the World Health Organization. This report demonstrated, for the first time, that 15 million babies are born preterm every year and there are stark regional and national level disparities in prevalence and survival rates.  Much work has been done to improve care of babies born too soon. With premature birth and its complications accounting for 35% of all newborn (<28 days) deaths worldwide, we must continue to discuss how we can save the lives of babies born too soon and help them thrive.

What more shall we talk about on this World Prematurity Day?  We propose a discussion on how we can reduce the preterm birth rates.  For reducing the rates of preterm birth; first and foremost, let’s promote the idea of educating men and women about planning a pregnancy.  Second, ensure that preconception health education and care are available to those who are planning a pregnancy.

In Chapter 3 of the Born too Soon report, significant emphasis was placed on the notion of preconception health as a way of preventing preterm birth by care before pregnancy and also in the inter-conception period. The chapter highlights the importance of preventing early age pregnancy, promoting optimal birth spacing, ensuring good nutritional health, and reducing risks of infections by vaccination and practicing good hygiene.  These areas of prevention are based on what we know are some of the factors associated with preterm birth.  Over the last decade, evidence in favor of preconception health has been mounting.  In 2018, a series of three articles on preconception health, published in the Lancet; the message was clear that preconception health programs need to be integrated into any national and global strategies that aim to improve adolescent health, nutritional health, maternal and child health outcomes, and to reduce the burden of non-communicable diseases.  At March of Dimes, we have for several years advocated for advancing pre-pregnancy health of women and men in low-and middle-income countries by promoting healthy lifestyle behaviors; the prevention, screening, diagnosing, and treatment of infections; reducing malnutrition and obesity; and improving access and utilization of contraception.

Publication of a number of reports this year have shown reduction of preterm birth rates in some high-income countries, for example, in the Netherlands, during the COVID-19 pandemic. These publications have peaked the curiosity of many researchers, funders and policy makers and reignited the interest in the notion of prevention of preterm birth. Although it is unclear how the pandemic is leading to reduction in premature birth rates, some colleagues have hypothesized that factors such as reduction in environmental pollution, reduced stress among working women, and increased practice of hygiene may be some of the factors to be credited.

So, on this World Prematurity Day, definitely talk about reducing disparities in the distribution of preterm births at all levels. Let’s also focus on saving lives of babies born premature and providing support to families of these babies. But, also let’s not forget that it is time to begin discussing prevention strategies through improving the health of women and their partners before, during, and after pregnancy.

About the Author

Dr. Walani is Vice President of Global Programs. She leads March of Dimes initiatives for improving maternal and newborn health in low- and middle-income countries. Professor Mishra is Head of the Epidemiology and Biostatistics Division and Professor of Life Course Epdemiology at the School of Public Health, University of Queensland (UQ). She is also a co-author of one of the articles in the Lancet Preconception Health Series.  


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