Prematurity now the second-leading cause of death worldwide in children under age 5

The first-ever national, regional, and global estimates of preterm birth reveals that 15 million babies are born too soon every year and 1.1 million of those babies die shortly after birth, making premature birth the second-leading cause of death in children under age 5.

Born Too Soon: The Global Action Report on Preterm Birth, highlight the need for more research into the causes of preterm birth and how to prevent it. According to the report, more than one in every 10 babies is born prematurely and preterm birth rates are increasing in almost all countries with reliable data. Survivors of premature birth often face a lifetime of disability, including serious infections, cerebral palsy, brain injury, and respiratory, vision, hearing, learning, and developmental problems.

Born Too Soon is a joint effort of almost 50 organizations, including the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children's.

"Even if every known intervention was implemented around the world, we would still see 13.8 million preterm births each year; we could only prevent 8 percent," said Craig Rubens, MD, PhD, executive director of GAPPS and contributor to the report. "This report sounds the alarm that prematurity is an enormous global health problem that urgently demands more research and resources."

New figures in the report show both the magnitude of the problem and the disparities between countries. Of the 11 countries with preterm birth rates over 15 percent, all but two are in sub-Saharan Africa. Preterm births account for 11.1 percent of the world's live births, 60 percent of them in South Asia and sub-Saharan Africa. In the poorest countries, on average, 12 percent of babies are born too soon, compared to 9 percent in higher-income countries.

However, the problem of preterm births is not confined to low-income countries. The United States and Brazil both rank among the top 10 countries with the highest number of preterm births. In the United States, about 12 percent, or more than one in nine births, are preterm.

"Treating premature infants is like trying to stop a snowball once it's 99 percent of the way down the mountain and has become an avalanche," Rubens said. "The emphasis needs to be on prevention strategies that work everywhere, especially in low-resource, high-burden settings."

GAPPS is committed to leading global research efforts to discover the causes and mechanisms of preterm birth and stillbirth. Research leadership includes stewarding the Preventing Preterm Birth initiative, a Grand Challenge in Global Health from the Bill & Melinda Gates Foundation; operating the GAPPS Repository of maternal and newborn samples and data for research of pregnancy and newborn health; and guidance on research harmonization.

Preterm birth is defined as babies born alive before 37 weeks of pregnancy are completed. More information on Born Too Soon: The Global Action Report on Preterm Birth is available at www.gapps.org.

Countries with the greatest numbers of preterm births

1. India - 3,519,100
2. China - 1,172,300
3. Nigeria - 773,600
4. Pakistan - 748,100
5. Indonesia - 675,700
6. United States - 517,400
7. Bangladesh - 424,100
8. Philippines - 348,900
9. Democratic Republic of the Congo - 341,400
10. Brazil - 279,300

Countries with the highest rates of preterm births for every 100 births

1. Malawi-18.1
2. Comoros and Congo-16.7
4. Zimbabwe-16.6
5. Equatorial Guinea-16.5
6. Mozambique-16.4
7. Gabon-16.3
8. Pakistan-15.8
9. Indonesia-15.5
10.Mauritania-15.4
54.United States-12.0