Introduction
Preterm infants have a gestational age below 37 weeks at birth and low-birth-weight (LBW) infants have a birth weight below 2.5 kg. Approximately 45% of all children under the age of five who die are newborns, and 60–80% of those newborns who die are premature and/or small for gestational age. Preterm and LBW infants have a 2- to 10-fold higher risk of mortality than infants born at term and with normal birth weight. Despite substantial progress over the last 10 years, the survival, health, growth and neurodevelopment of preterm and LBW infants remains concerning in many countries. Reasons include the complexities of caring for these vulnerable infants and preventing complications.
The care of preterm and LBW infants is a global priority. The WHO Departments of Maternal, Newborn, Child and Adolescent Health and Ageing (MCA) and Sexual and Reproductive Health and Research (SRH) have developed three guidelines for the care of preterm or LBW infants:
- Guidelines on optimal feeding of low-birth-weight infants in low- and middle-income countries, 2011;
- WHO recommendations on interventions to improve preterm birth outcomes, 2015; and
- Recommendations for management of common childhood conditions, 2012.
However, new evidence has emerged in many areas since the development of those guidelines. A review of 203 studies from low-, middle- and high-income countries about “what matters” to families about the care of their preterm or LBW infant reported that families want a positive outcome for their baby, to be involved in delivering care and to take an active role in deciding what interventions are given to their baby.
In December 2020, an international group of experts defined the scope and priority questions for the development of updated guidance about the care of preterm or LBW infants. This document contains the updated guidance.