Cape Town - A new report is sounding the alarm on the “silent emergency” of preterm birth as long under-recognised in its scale and severity, and impeding progress in improving children’s health and survival.
An estimated 13.4 million babies were born preterm in 2020, with nearly 1 million dying from preterm complications. This is equivalent to around one in 10 babies born early (before 37 weeks of pregnancy) worldwide.
Born too soon: decade of action on preterm birth, produced by the World Health Organization (WHO) and the UN Children’s Fund (Unicef) together with the Partnership for Maternal, Newborn & Child Health, the world’s largest alliance for women, children, and adolescents, includes updated estimates from WHO and Unicef, prepared with the London School of Hygiene and Tropical Medicine, on the prevalence of preterm births.
Overall, it found 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 one in five 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.
Too often, where babies are born determines if they survive, and the report notes that only one in 10 extremely preterm babies (<28 weeks) survive in low-income countries, compared to more than nine in 10 in high-income countries.
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.
“Southern Asia and sub-Saharan Africa have the highest rates of preterm birth, and preterm babies in these regions face the highest mortality risk,” the report reads.
The report also highlights the impacts of conflict, climate change and environmental damage.
For example, 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.
Stellenbosch University epidemiologist Dr Jo Barnes said the increase in numbers of preterm babies kept pace with the increase in the population, but the survival of those babies depended critically on where they were born.
“The number of preterm babies dying in the developed world is very low when compared to those dying in the underdeveloped or developing world. That means that it is theoretically possible to save many more of them, but a number of factors (poor health services, poor access to those services, poor health of expectant mothers, etc) count against them.
“The aims of this report should be taken seriously by health authorities all over the world, but particularly so in a country like South Africa.
“Any organisation dealing with the welfare of children should put pressure on the government to step up their care of pregnant mothers and their obstetric services all over the country, not only in the towns and cities, so that so many children born into poor families can have a better chance of a healthy and productive life,“ she said.