Preterm birth rates have not changed in any region in the world over the past decade, with 152 million vulnerable babies born too soon from 2010 to 2020. Shockingly, 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 5th birthday. Survivors of preterm birth can face lifelong health consequences, with an increased likelihood of disability and developmental delays. 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.
Prof Joy Lawn, co-lead of the report and director of the London School of Hygiene & Tropical Medicine, states that "after every preterm death is 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 devastating. It’s time we improve access to care for pregnant mothers and preterm infants and ensure every child gets a healthy start and thrives in life."
The report highlights that preterm birth rates are the highest in Southern Asia and sub-Saharan Africa, where preterm babies also face the highest mortality risk. In these regions, over 65% of preterm births occur. Furthermore, the report notes that only 1 in 10 extremely preterm babies (<28 weeks) survive in low-income countries, compared to more than 9 in 10 in high-income countries. The impacts of conflict, climate change and environmental damage, COVID-19, and rising living costs are also increasing risks for women and babies everywhere. For instance, air pollution is estimated to contribute to 6 million preterm births each year.
Maternal health risks, such as adolescent pregnancy and pre-eclampsia, are closely linked to preterm births. The report emphasizes 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. The past decade has seen a growth of community activism on preterm birth and stillbirth prevention, driven by networks of parents, health professionals, academia, civil society, and others. Throughout the world, groups for affected families of preterm birth have been advocating for access to better care and policy change, as well as supporting other families.
The report presents an agenda for action, calling for increased investments, accelerated implementation, integration across sectors, and locally driven innovation. WHO, UNICEF, UNFPA and PMNCH are urging the mobilization of international and domestic resources to optimize maternal and newborn health, ensuring high-quality care is provided when and where it is needed. They are also promoting education through the life cycle, supporting smarter economic investments, strengthening climate adaptation responses, and advancing the coordination and resilience of emergency systems. Lastly, they call for investing in locally led innovation and research to support improvements in the quality of care and equity in access.