The World Health Organization (WHO) has updated its fact sheet on preterm births recently.

Background Information:

Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, based on gestational age:

• extremely preterm (less than 28 weeks)
• very preterm (28 to 32 weeks)
• moderate to late preterm (32 to 37 weeks).

Induction or caesarean birth should not be planned before 39 completed weeks unless medically indicated.

Common causes of preterm birth include

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

however, often no cause is identified.

Key Messages:

The Problem

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 approximately 1 million deaths in 2015. Many survivors face a lifetime of disability, including learning disabilities and visual and hearing problems.

Three-quarters of these deaths could be prevented with current, cost-effective interventions.

Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born.

More than 60% of preterm births occur in Africa and South Asia, but preterm birth is truly a global problem. In the lower-income countries, on average, 12% of babies are born too early compared with 9% in higher-income countries. Within countries, poorer families are at higher risk.

The 10 countries with the greatest number of preterm births:

• India: 3 519 100
• China: 1 172 300
• Nigeria: 773 600
• Pakistan: 748 100
• Indonesia: 675 700
• United States of America: 517 400
• Bangladesh: 424 100
• Philippines: 348 900
• Democratic Republic of the Congo: 341 400
• Brazil: 279 300

In low-income settings, half of the babies born at or below 32 weeks (2 months early) die due to a lack of feasible, cost-effective care, such as

• warmth,
• breastfeeding support, and
• basic care for infections and breathing difficulties.

In high-income countries, almost all of these babies survive.

The Solution:

More than three quarters of premature babies can be saved with feasible, cost-effective care, such as

• essential care during child birth and in the postnatal period for every mother and baby,
• provision of 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.

For example, continuity of midwifery-led care in settings where there are effective midwifery services has been shown to reduce the risk of prematurity by around 24%.

Useful Links:

Link to the updated fact sheet:

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

Link to WHO page on prematurity and care of low birth weight babies:

http://who.int/maternal_child_adolescent/newborns/prematurity/en/

Link to WHO’s Question and Answer page on prematurity:

http://who.int/features/qa/preterm_babies/en/

Link to WHO global action report on preterm birth:

http://who.int/maternal_child_adolescent/documents/born_too_soon/en/

Link to WHO recommendations on interventions to improve preterm birth outcomes:

http://who.int/reproductivehealth/publications/maternal_perinatal_health/preterm-birth-guideline/en/

Link to WHO guide on Kangaroo Mother Care:

http://who.int/maternal_child_adolescent/documents/9241590351/en/

Link to WHO’s Every Newborn Action Plan:

http://who.int/maternal_child_adolescent/newborns/every-newborn/en/