The report, called "Born Too Soon: The Global Action Report on Preterm Birth", informs that over 1 million premature babies die soon after they are born, while several million more suffer from physical, neurological or educational disabilities.
The economic burden of these disabilities to family members and society overall is considerable. The report also includes the first ever country ranking of preterm birth rates.
Joy Lawn, M.D., PhD, co-editor of the report and Director, Global Evidence and Policy for Save the Children's Saving Newborn Lives program, said:
"Being born too soon is an unrecognized killer. Preterm births account for almost half of all newborn deaths worldwide and are now the second leading cause of death in children under 5, after pneumonia, and six times more than child deaths due to AIDS."
There are huge disparities between countries regarding preterm births and associated mortalities. All but 2 of the 11 countries with preterm birth rates over 15% are in sub-Saharan Africa. 60% of all preterm births worldwide occur in South Asia and sub-Saharan Africa.
The authors emphasize, however, that preterm birth really is a worldwide problem. Brazil and USA are among the 10 countries with the highest number of preterm births. In the USA, 12% of all babies are born premature, that is more than 1 in every nine births - twice as many in the majority of European countries (twice as many as in China).
The following nations have the highest number of preterm births:
- 3,519,100 - India
- 1,172,300 - China
- 773,600 - Nigeria
- 748,100 - Pakistan
- 675,700 - Indonesia
- 517,400 - United States
- 424,100 - Bangladesh
- 348,900 - Philippines
- 341,400 - Democratic Republic of the Congo
- 279,300 - Brazil
- Malawi - 18.1 per 100
- Comoros and Congo - 16.7 per 100
- Zimbabwe - 16.6 per 100
- Equatorial Guinea - 16.5 per 100
- Mozambique - 16.4 per 100
- Gabon - 16.3 per 100
- Pakistan - 15.8 per 100
- Indonesia - 15.5 per 100
- Mauritania - 15.4 per 100
- Belarus - 4.1
- Ecuador - 5.1
- Latvia - 5.3
- Finland, Croatia, and Samoa - 5.5
- Lithuania and Estonia - 5.7
- Antigua/Barbuda - 5.8
- Japan and Sweden - 5.9
"The numbers of preterm births are increasing. Of the 65 countries with reliable trend data for preterm birth rates, all but 3 countries have shown increases in the last 20 years. Worldwide, 50 million births still happen at home and many babies die without birth or death certificates. These first ever country estimates give us a clear picture of how many babies are born too soon and how many die."
Why are preterm birth rates rising in rich countries?Several factors have contributed to a rising rate of preterm births in high-income nations, including:
- More older women are giving birth than before
- More women are using fertility drugs to get pregnant, which increases the number of multiple pregnancies
- More women of reproductive age have diabetes
- More women of reproductive age are obese
- There are more inductions and C-sections before full-term, many of which are medically not unnecessary
However, many preterm births are unexplained in both poor and rich nations.
Pre-term birth rates vary widely within some countriesIn the United States in 2009:
- The African-American preterm birth rate was 17.5%
- The Caucasian pre-term birth rate was 10.9%
- For women aged 20 to 35 years, the preterm birth rate was between 11% and 12%
- For women aged under 17 and over 40 years, the preterm birth rate was over 15%
Pre-term death rates vary widely around the worldLow-income countries - over 90% of babies born three months early die
High-income countries - less than 10% of babies born three months early die
Dr. Lawn stressed:
"This 90: 10 survival gap means these babies are not just born too soon - they are born to die, with even their families not knowing there are highly effective solutions that could save their lives.
A number of countries, for example, Ecuador, Turkey, Oman and Sri Lanka have halved their neonatal deaths from preterm birth through improving care of serious complications like infections and respiratory distress."
Three-quarters of preterm babies who die could be savedExperts say that approximately 75% of the preterm babies who currently die worldwide could be saved, with inexpensive care if proven treatments and preventions were available and used.
To bring pre-term mortality down significantly, health systems need a good number of well-qualified frontline workers, especially nurses and midwives.