Born too soon: preterm birth matters

Abstract

Urgent action is needed to address preterm birth given that the fi rst country-level estimates show that globally 15 million babies are born too soon and rates are increasing in most countries with reliable time trend data. As the fi rst in a supplement entitled “Born Too Soon”, this paper focuses on the global policy context. Preterm birth is critical for progress on Millennium Development Goal 4 (MDG) for child survival by 2015 and beyond, and gives added value to maternal health (MDG 5) investments also linking to non-communicable diseases. For preterm babies who survive, the additional burden of prematurity-related disability may aff ect families and health systems. Prematurity is an explicit priority in many high-income settings; however, more attention is needed especially in low- and middle-income countries where the invisibility of preterm birth as well as its myths and misconceptions have slowed action on prevention and care. Recent global attention to preterm birth hit a tipping point in 2012, with the May 2 publication of Born Too Soon: The Global Action Report on Preterm Birth and with the 2nd annual World Prematurity Day on November 17 which mobilised the actions of partners in many countries to address preterm birth and newborn health. Interventions to strengthen preterm birth prevention and care span the continuum of care for reproductive, maternal, newborn and child health. Both prevention of preterm birth and implementation of care of premature babies require more research, as well as more policy attention and programmatic investment.

Figure 1

Millennium Development Goal 4 Progress. Source: Adapted from Lawn et al., 2012. Data from UN Interagency Group for Child Mortality Estimates (UNICEF, 2013) and the Institute for Health Metrics and Evaluation (Lozano et al., 2011). Note: MDG 4 target reflects a 2/3 reduction from the under-5 mortality rate in 1990.

Figure 2

How the Millennium Development Goals Link to Prevention and Care of Preterm Births. Source: Born Too Soon report [5].

Figure 3

Every Woman, Every Child and now Every Newborn. From Born Too Soon report [5].

Figure 4

Myths and misconceptions of preterm birth. From Born Too Soon report [5].

Figure 5

Milestones in the development of global awareness and action to tackle the problem of newborn survival.

Figure 6

The Continuum of Care for reproductive, maternal, newborn and child health through the life cycle according to levels of health service delivery. Source: Born Too Soon report [5], adapted from Kerber et al. 2007 [33].