Each year, some 15 million babies in the world are born too early. More than one million of those babies die shortly after birth; countless others suffer some type of lifelong physical, neurological, or educational disability, often at great cost to families and society.
An estimated three-quarters of those preterm babies who die could survive without expensive care if a few proven and inexpensive prevention and treatment strategies were implemented worldwide, according to the report, Born Too Soon: The Global Action Report on Preterm Birth, authored by a broad group of 45 international multi-disciplinary experts from 26 organisations – including the Aga Khan University – and 11 countries with over 40 organisations in support.
“All newborns are vulnerable, but preterm babies are acutely so,” says UN Secretary General Ban Ki-moon, who wrote the foreword to the report and considers the effort to reduce preterm births and deaths an integral part of his Global Strategy for Women’s and Children’s Health.
Preterm births account for more than one in 10 of the world's live births, and sixty percent of them occur in South Asia and sub-Saharan Africa. Pakistan with 748,100 preterm births annually has the fourth highest number after India at 3,519,100; China at 1,172,300 and Nigeria at 773,600. Not too far behind is Tanzania, number 12 on the list followed by Uganda at 14, and Kenya at 15.
Worse, Pakistan is eighth of the top 10 countries with the highest rates of preterm births: 15.8 for every 100 births along, again, with countries from sub-Saharan Africa: Malawi, 18.1 per 100; Comoros and Congo,16.7; Zimbabwe,16.6; Equatorial Guinea, 16.5; Mozambique,16.4; Gabon,16.3; Indonesia,15.5; and Mauritania, 15.4. The rate for the East African countries of Uganda, Kenya and Tanzania are at 13.6, 12.3, and 11.4 respectively.
“For too long prematurity has been regarded as synonymous with a limited chance of survival. Our studies suggest that several low cost solutions are possible for the care of women before and during pregnancy and importantly after preterm birth. These have huge potential for saving lives and improving pregnancy outcomes,” says Dr Zulfiqar Bhutta, Founding Chair of Women and Child Health at the Aga Khan University, and one of the authors of the report.
Inexpensive and simple techniques save lives
Basic measures such as antenatal steroid injections for mothers in premature labour; ‘kangaroo care’ where the infant is held skin-to-skin on the mother's chest for warmth and ease of breastfeeding; antiseptic cream to prevent birth cord infection; and antibiotics to prevent and fight infection, an important cause of neonatal death, are all inexpensive, proven forms of care for premature babies that could dramatically improve the chances of survival.
Prevention key to reducing premature births
A key way to reduce the number of preterm birth is to ensure that all pregnancies go to full term, or 39 weeks. Until research provides better answers, the report advises taking effective measures now, such as screening women for known medical conditions that could put them at risk during pregnancy, assuring good nutrition before and during pregnancy and making sure that all women have access to good preconception and prenatal health care and that they are able to visit their doctor regularly during pregnancy.
The lead authors of the report representing the March of Dimes Foundation, The Partnership for Maternal, Newborn & Child Health, Save the Children and the World Health Organization offer a detailed action plan to reduce the number of global preterm births as well as the associated fatalities.