A new report raises the alarm about a “silent emergency” that goes unnoticed and unrecognized

An estimated 13.4 million babies were born pre-term in 2020, with nearly 1 million dying from preterm complications says a new report released by the WHO and the UNICEF together with the Partnership for Maternal, Newborn and Child Health (PMNCH).

The report says 152 million vulnerable babies were born too soon from 2010 to 2020.

Preterm birth (babies born before the 37th week of pregnancy) 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. And preterm survivors can face lifelong health consequences, with an increased likelihood of disability and development delays.

The UN agencies sound the alarm on the “silent emergency,” long under-recognized in its scale and severity, which is impeding progress in improving children’s health and survival.

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India among top 5 countries where babies are born too soon

The report says almost half of all pre-term births happened in five countries – India, Pakistan, Nigeria, China and Ethiopia. Together they accounted for 45 percent of babies born too soon around the world, exposing them to a high mortality risk.

The total pre-term birth numbers for the five countries are alarming indeed, as India tops the list with 30.16 lakh births, Pakistan is at 9.14 lakh, Nigeria at 7.74 lakh and China at 7.52 lakh.

In 2020, Bangladesh had the highest estimated preterm birth rate (16.2 percent), followed by Malawi (14.5 percent) and Pakistan (14.4 percent).

India and South Africa, at an estimated 13 percent each, were among the top five countries with high pre-term birth rates.

Survival gaps by region, income, race

The report finds that preterm birth rates have not changed in any region in the world in the past decade.

It provides a comprehensive overview of the prevalence of preterm birth and its profound impact on women, families, societies and economies.

Too frequently, a baby’s survival is determined by where they are born. The report notes that only 1 in 10 extremely preterm babies- born before 28 weeks – survive in low-income countries, compared to more than 9 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.

Together, these two regions account for more than 65 percent 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.

Maternal health risks, such as adolescent pregnancy and pre-eclampsia, are closely linked to preterm births. 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.

Agenda for action

The report notes that 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. WHO, UNICEF, UNFPA and PMNCH have called for actions such as increased investments and accelerated implementation to improve care for women and newborns and mitigate risks from preterm births.

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