The World Health Organization has recently updated its fact sheet on preterm birth.

Background Information:

Preterm is defined as babies born alive before the completion of 37 weeks of pregnancy.

There are sub-categories of preterm birth, based on gestational age:

• extremely preterm (<28 weeks)
• very preterm (28 to <32 weeks)
• moderate to late preterm (32 to <37 weeks)

Most preterm births happen spontaneously, but some are due to early induction of labour or caesarean birth, whether for medical or non-medical reasons.

Common causes of preterm birth include

• multiple pregnancies
• infections
• chronic conditions such as diabetes and high blood pressure;

However, often no cause is identified.

There could also be a genetic influence.

Key Messages:

Every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising.

Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for nearly 1 million deaths in 2013.

Three-quarters (75%) of them could be saved with current, cost-effective interventions such as

• warmth
• breastfeeding support
• basic care for infections and breathing difficulties
• essential care during child birth and in the postnatal period for every mother and baby
• antenatal steroid injections (given to pregnant women at risk of preterm labour and under set criteria to strengthen the babies’ lungs)
• kangaroo mother care (the baby is carried by the mother with skin-to-skin contact and frequent breastfeeding) and
• antibiotics to treat newborn infections.

There is a dramatic difference in survival of premature babies depending on where they are born:

• more than 90% of extremely preterm babies (<28 weeks) born in low-income countries die within the first few days of life;
• less than 10% of babies of this gestation die in high-income settings.
• In low-income settings, half of the babies born at or below 32 weeks (2 months early) die  
• In high-income countries, almost all of these babies survive.

More than 60% of preterm births occur in Africa and South Asia, but preterm birth is truly a global problem.

Top 5 countries by number of preterm births:

• India: 3, 519, 100
• China: 1, 172, 300
• Nigeria: 773, 600
• Pakistan: 748, 100
• Indonesia: 675, 700

Top 5 countries by rate of preterm births per 100 live births:

• Malawi: 18.1 per 100
• Comoros: 16.7
• Congo: 16.7
• Zimbabwe: 16.6
• Equatorial Guinea: 16.5

Useful Links:

Link to the updated fact sheet:

http://www.who.int/mediacentre/factsheets/fs363/en/

Link to Guideline ‘WHO recommendations to improve outcomes in preterm births’ (2015):

http://apps.who.int/iris/bitstream/10665/183037/1/9789241508988_eng.pdf?ua=1

Link to the evidence base for the guidelines:

http://apps.who.int/iris/bitstream/10665/183038/1/WHO_RHR_15.17_eng.pdf?ua=1