Premature

Premature

Every year, an estimated 15 million babies are born premature (before 37 completed weeks of gestation), and this number is rising. Premature birth complications are the leading cause of death among children 5 years of age and under. This accounts for nearly 1 million deaths in 2013. Three-quarters of them could be saved with up-to-date and cost-effective interventions. The rate of premature births ranges from 5% to 18% of babies born across 184 countries.

Premature/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 (<28 weeks), very preterm (28 to <32 weeks), moderate to late preterm (32 to <37 weeks).  Induction or cesarean birth should not be planned before 39 completed weeks unless medically indicated.

The problems are an estimated 15 million babies are born too early every year. That is more than 1 in 10 babies. Almost 1 million children die each year due to complications of preterm birth. Many survivors face a lifetime of disability, including learning disabilities and visual and hearing problems. Globally, prematurity is the leading cause of death in children 5 and under. And in almost all countries with reliable data, preterm birth rates are increasing.  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 solutions are more than three-quarters of premature babies can be saved with feasible, cost-effective care, 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 labor 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.  To help reduce premature birth rates, women need improved care before, between and during pregnancies. Better access to contraceptives and increased empowerment could also help reduce preterm births.

Premature birth occurs for a variety of reasons. Most premature births happen spontaneously, but some are due to early induction of labor or cesarean birth, whether for medical or non-medical reasons.  Common causes of premature birth include multiple pregnancies, infections and chronic conditions such as diabetes and high blood pressure; however, often no cause is identified. There could also be a genetic influence. Better understanding of the causes and mechanisms will advance the development of solutions to prevent premature birth.