The full text of the article can be viewed in The Lancet
Although important gains have been made in child survival over the past two decades, reduction in neonatal mortality (ie, deaths in the first month of life) has lagged substantially. Neonatal deaths now account for 44% of all under-5 deaths worldwide.1 Preterm birth is the leading cause of neonatal death, the second leading cause of all under-5 mortality,2 and a leading cause of severe childhood neurological disability. Despite this high global burden, little is known about how to prevent preterm birth and, in low-income and middle-income countries, how best to scale up strategies that are practical and affordable.
Preterm birth is a final common pathway for many complex pathological processes. A comprehensive research agenda is therefore needed to accelerate identification of mediators of preterm birth and innovative solutions. To forge a road map for this action agenda, the Bill & Melinda Gates Foundation (BMGF), the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), March of Dimes (MOD), the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and WHO convened meetings of experts to develop a research agenda that spans the range of discovery, development, and delivery science needed to drive global change. This Comment summarises this solution pathway (figure) and the next steps toward its implementation.
The schematic summarises key elements of the solution pathway for preterm birth research, across the range of discovery, development, and delivery science. The agenda is global in its approach; strategies more relevant to high-income countries are in pink, and low-income and middle-income countries (LMIC) in grey. CPAP = continuous positive airway pressure. EmONC = emergency obstetric and newborn care. RMNCH = reproductive, maternal, newborn, and child health.