‘Silent emergency’: Preterm complications claim a million lives yearly

An estimated 13.4 million babies were born pre-term during the period between 2010 to 2020, with nearly 1 million dying from related complications, according to a new report released by United Nations agencies.

Produced by a range of agencies, including the UN Children’s Fund (UNICEF) and the World Health Organization (WHO), the report outlines a strategy forward to address this phenomenon, which has been long under-recognized in its scale and severity.

Southern Asia and sub-Saharan Africa have the highest rates of preterm birth, and preterm babies in these regions face the highest mortality risk. Together, these two regions account for more than 65% of preterm births globally.

The report also highlights that the impacts of conflict, climate change and environmental damage, COVID-19, and rising living costs are increasing risks for women and babies everywhere. For example, air pollution is estimated to contribute to 6 million preterm births each year.  Nearly 1 in 10 preterm babies are born in the 10 most fragile countries affected by humanitarian crises, according to a new analysis in the report.

Progress is ‘flatlining’

“Progress is flatlining for maternal and newborn health, as well as the prevention of stillbirths,” Executive Director Helga Fogstad of Partnership for Maternal, Newborn and Child Health said.

Gains made are now being pushed back further through the devastating combination of COVID-19, climate change, expanding conflicts and rising living costs, she warned.

“By working together in partnership – governments, donors, the private sector, civil society, parents, and health professionals – we can sound the alarm about this silent emergency,” she said.

This means bringing preterm prevention and care efforts to the forefront of national health and development efforts, building human capital by supporting families, societies, and economies everywhere, she added.

Born too soon

Preterm birth rates have not changed in any region in the world in the past decade, with 152 million vulnerable babies born too soon from 2010 to 2020, the report showed.

Preterm births occur earlier than 37 weeks of an expected 40-week full-term pregnancy.

Leading cause of child deaths

Dr Anshu Banerjee, Director for Maternal, Newborn, Child and Adolescent Health and Ageing at WHO said “Ensuring quality care for these tiniest, most vulnerable babies and their families is absolutely imperative for improving child health and survival. Progress is also needed to help prevent preterm births — this means every woman must be able to access quality health services before and during pregnancy to identify and manage risks.”

Steven Lauwerier, Director of Health at UNICEF, noted that every preterm death created “a trail of loss and heartbreak”.

“Despite the many advances the world has made in the past decade, we have made no progress in reducing the number of small babies born too soon or averting the risk of their death. The toll is devasting. It’s time we improve access to care for pregnant mothers and preterm infants and ensures every child gets a healthy start and thrives in life.”

Preterm birth is now the leading cause of child deaths, accounting for more than one in five of all deaths of children occurring before their fifth birthday, the report said. Preterm survivors can face lifelong health consequences, with an increased likelihood of disability and developmental delays, according to the report.

Too often, where babies are born, determines if they survive, the report found, noting that only 1 in 10 extremely preterm babies survive in low-income countries, compared to more than nine in 10 in high-income nations, it said.

Maternal health risks, such as adolescent pregnancy and pre-eclampsia, are closely linked to preterm births, the report said, adding that this underlines the need to ensure access to sexual and reproductive health services, including effective family planning, with high-quality care in pregnancy and around the time of birth.

152 million babies born preterm in the last decade

The report includes updated estimates on the prevalence of preterm births. Overall, it finds that preterm birth rates have not changed in any region in the world in the past decade, with 152 million vulnerable babies born too soon from 2010 to 2020.

Preterm birth is now the leading cause of child deaths, accounting for more than 1 in 5 of all deaths of children occurring before their fifth birthday. Preterm survivors can face lifelong health consequences, with an increased likelihood of disability and developmental delays.

The cost of inaction over the last decade was 152 million babies born too soon. While some regions are more affected, preterm birth threatens health progress in every country, it said, adding that greater investment in the care of vulnerable new-borns can save millions of families from heartbreak.

The report showed gaping inequalities related to race, ethnicity, income, and access to quality care, determine the likelihood of preterm birth, death, and disability, even in high-income countries.

At the same time, nearly one in 10 preterm babies are born in the 10 most fragile countries affected by humanitarian crises, according to a new analysis in the report.

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