Today, November 17, is observed as World Prematurity Day to raise awareness on the incidence of premature births across the globe. Globally, India has the highest preterm births in the world.
According to the World Health Organization (WHO), India reported the highest number of preterm births in 2020 at 3.02 million which accounted for over 23 per cent of all preterm births worldwide. An estimated 13.4 million babies were born prematurely early in 2020. That is more than 1 in 10 babies.
Premature or preterm birth is one where a baby is born before 37 weeks of pregnancy are completed.
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The WHO report titled Born too soon: decade of action on preterm birth stated that preterm birth remains the fourth leading cause of loss of human deaths worldwide at all ages (after heart disease, pneumonia and diarrhoeal disease).
It accounts for a greater global burden than chronic obstructive airways disease, diabetes or stroke. Preterm births are of three types: extremely preterm (less than 28 weeks) , very preterm (28 to less than 32 weeks) , moderate to late preterm (32 to 37 weeks).
“Inequalities in care between and within countries result in unacceptably large survival gaps for babies born preterm. Higher-resourced settings have near-universal survival for those born over 28 weeks’ gestation, compared to much higher mortality among babies, even up to 32 weeks’ gestation, in places where access to care is limited,” the report added.
Long term consequences of pre-mature births
Also, as per WHO many of those infants that survive a premature birth face a lifetime of disability, including learning disabilities and visual and hearing problems. Preterm birth occurs for a variety of reasons. Most preterm births happen spontaneously, but some are due to medical reasons such as infections, or other pregnancy complications that require early induction of labour or caesarean (surgical intervention) birth.
“More research is needed to determine the causes and mechanisms of preterm birth. Causes include multiple pregnancies, infections and chronic conditions such as diabetes and high blood pressure; however, often no cause is identified. There could also be a genetic influence,” WHO mentioned.
A majority of preterm births occur in southern Asia and sub-Saharan Africa, but preterm birth is a global problem.
“There is a dramatic difference in survival of premature babies depending on where they are born. For example, more than 90% of extremely preterm babies (less than 28 weeks) born in low-income countries die within the first few days of life, yet less than 10% of extremely preterm babies die in high-income settings,” it said.
WHO’s recommendations
Preventing deaths and complications from preterm birth starts with a healthy pregnancy.
WHO’s antenatal care guidelines include interventions to help prevent preterm birth, such as providing counselling to the pregnant mothers on healthy diets, optimal nutrition, and advising them against tobacco and substance use.
It also calls for timely foetal measurements including use of early ultrasound to help determine gestational age and detect multiple pregnancies; and a minimum of eight contacts with health professionals through the pregnancy – starting before 12 weeks – to identify and manage risk factors such as infections.
“If a woman experiences preterm labour or is at risk of preterm childbirth, treatments are available to help protect the preterm baby from future neurological impairment as well as difficulties with breathing and infection. These include antenatal steroids and tocolytic treatments to delay labour and antibiotics for preterm prolabour rupture of membranes (PPROM),” WHO mentioned.
