According to a new report released this Wednesday, nearly 15 million premature babies are born every year - more than 1 in 10 of the world's births. This is considered by experts an obstetric epidemic. 1.1 million of these fragile new born babies die as a result, and even those who survive can suffer lifelong disabilities. Further most of these babies are born in Africa and Asia the report adds.
The WHO defines a preterm birth as before completion of the 37th week of pregnancy. Most preemies fall in the “late preterm” category, born between 32 and 37 weeks. Extreme preemies are born before 28 weeks. So-called “very preterm” babies fall in between.
The report, three years in the making, is the first to compare premature birth rates in 184 countries. It was produced jointly by the W.H.O., Save the Children, the March of Dimes and the Partnership for Maternal, Newborn and Child Health, which has more than 400 member organizations. Other contributors include nearly 40 major American, European and United Nations health and foreign aid agencies and foundations.
Nine of the 11 countries in which 15 percent or more of all births are preterm are in Africa; the other two are Pakistan and Indonesia. The United States shares the 12 percent range with Kenya, Turkey, Thailand, East Timor and Honduras, meaning one in 9 births is early. The rate in the United States has risen 30 percent since 1981. Most European countries, Canada and Australia are in the 7 to 9 percent range.
The starkest difference between rich and poorer countries, however, is survival. “Being born too soon is an unrecognized killer,” said Dr. Joy Lawn of Save the Children, who co-authored the report with the March of Dimes, World Health Organization and a coalition of international health experts. “And it's unrecognized in the countries where you could have a massive effect in reducing these deaths.” Sophisticated and expensive intensive care saves the majority of preterm babies in the U.S. and other developed nations, even the tiniest, most premature ones. The risk of death from prematurity is at least 12 times higher for an African new born than for a European baby, the report found.
Globally, prematurity is not only the leading killer of new born babies but the second-leading cause of death in children under 5. “These facts should be a call to action,” United Nations Secretary-General Ban Ki-moon wrote in an introduction to the report. Three-quarters of the deaths could be prevented by spreading some simple, inexpensive treatments to the neediest countries, the report concludes. For example, providing $1 steroid shots during preterm labor hastens development of immature fetal lungs. They're standard in developed countries; wider use in low-income countries could save nearly 400,000 babies a year.
Even more lives could be saved by teaching “kangaroo care,” in which moms carry their tiny babies nestled skin-to-skin on their bare chests for warmth when there are no incubators. “To see babies who are 900 grams (about 2 pounds) survive without any technology, it's fantastic,” says Lawn, who has watched kangaroo care save lives in countries like Malawi, with the highest preterm birth rate - 18.1 per cent.
Antibiotics are also needed to fight the infections that often kill new born babies, and antiseptic cream to prevent umbilical cord infection. Survival is not the only hurdle. No one knows how many preemies suffer disabilities including cerebral palsy, blindness or learning disorders.
Previously, the groups had estimated that 13 million babies were born prematurely each year, based on regional data. About 12 per cent of US births are preterm, about the same as Wednesday's report estimates in Thailand, Turkey and Somalia. In contrast, just 5.9 per cent of births in Japan and Sweden are premature. The high rates is US can be due to poorer access to prenatal care for uninsured US women, especially minority mothers-to-be, said March of Dimes epidemiologist Christopher Howson. African-American women are nearly twice as likely as white women to receive late or no prenatal care, and they have higher rates of preterm birth as well, he said. Whatever the precise numbers, “we have a shared problem among all countries and we need a shared solution,” Howson said.
Dr. Gordon C. S. Smith, an expert at the University of Cambridge, noted that his native Scotland had many of the same risk factors as the United States — teenage pregnancies, poverty, obesity and older mothers — and yet has much lower rates. “If somebody had a simple explanation of why the U.K. and Europe do much better, I wouldn’t believe them,” he said. “The reality is, for most preterm births, we just don’t understand the cause.”
Andy Cole, from premature baby charity Bliss, said “it is worrying that the UK's preterm birth rate is significantly higher than countries such as Sweden, Norway and Ireland, and highlights the need for well-co-ordinated and high-quality antenatal care for all women identified as high risk”.
Not just early prenatal care but more preconception care is needed, he said. Given that in the US alone, nearly half of pregnancies are unplanned, health providers should use any encounter with a woman of childbearing age to check for factors that could imperil a pregnancy. “Ensure that mom goes into her pregnancy as healthy as possible,” Howson said.
Risk factors for preterm birth include, maternal diabetes, high blood pressure, infections and smoking, being underweight or overweight, and spacing pregnancies less than two years apart. Getting pregnant before age 17 or over 40, carrying twins or more and in wealthier countries, early elective inductions and C-sections are reasons for preemies. “A healthy baby is worth the wait,” Howson said, noting that being even a few weeks early can increase the risk of respiratory problems, jaundice, even death.
Top 10 Countries that rank highest in preterm birth rates in 2010 were India, China, Nigeria, Pakistan, Indonesia, United States of America, Bangladesh, Philippines, Dem. Rep. of Congo and Brazil.
It is hoped the report will focus on premature births, especially in sub-Saharan Africa, and make it an urgent priority to help reach the UN Millennium Development Goal 4 set in 2000 - which calls for the reduction of young child deaths by two-thirds in 2015.
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