A first-ever global study
of pre-term births has found nearly 15 million babies were born prematurely around the world in 2010, putting them at increased risk for illness, disability and early death.
The authors say premature delivery is a problem not only in poor developing countries but in affluent developed nations as well, including the United States.
Researchers with the non-governmental organization Save the Children analyzed data from national health registries and reproductive surveys done in 84 countries, and concluded that more than one in ten babies is born prematurely. Sixty percent of these more perilous early births are occurring in south Asia and sub-Saharan Africa.
A pregnancy of at least 40 weeks gestation is considered full-term. In pregnancies that are less than 32 weeks in duration, complications, including the risk of death to the newborn, increase dramatically. Babies born early are more likely to develop learning disabilities and eyesight problems, and a neurological condition called cerebral palsy.
Joy Lawn of Save the Children in South Africa led the team of researchers that wrote the report on pre-term births for the World Health Organization. According to Lawn, fatal complications from early delivery are the second most common cause of death among children under the age of 5, accounting for 1.1 million deaths globally every year.
Eighty-four percent of premature infants are born between 32 and 37 weeks. With proper medical care and loving attention, Lawn says, these newborns stand a good chance of surviving.
"They would survive with really basic care. So, being breastfed, being kept warm," she says. "And they are at much higher risk of infection; so treating with antibiotics."
Lawn adds only five percent of the 15 million pre-term babies were born at 28 weeks or less, and those that survived birth required intensive -- and expensive -- neo-natal care in a hospital.
In 65 countries that collected reliable data over the past 20 years -- mostly in developed regions, Latin America and the Caribbean -- Lawn and colleagues found the average rate of pre-term deliveries increased from 7.5% of all live births in 1990 to 8.6% in 2010.
According to the Save the Children research team, 15 countries -- including the United States and Brazil -- account for two-thirds of the world's preterm births. The other countries on that list are Pakistan, India, Bangladesh, China, Indonesia and the Philippines, as well as Nigeria, Kenya, Sudan, Uganda, Ethiopia and the Democratic Republic of Congo.
Only three countries -- Croatia, Ecuador and Estonia -- had a decrease in their preterm birth rates between 1990 and 2010.
Lawn says the reduction in premature births in Croatia may be due to the fact that the country is no longer at war and has more resources to devote to prenatal or pregnancy care.
In Ecuador and Estonia, Lawn says there have been improvements in income and with it, the general status of women.
"But really we can't point to one solution and say this is what caused it." she says. "Just as we couldn't point to something in the U.S. and say this is what caused the very high rates in the U.S."
In the United States, researchers report there were 517-thousand premature births in 2010, accounting for twelve percent of live births per year.
Save the Children's global survey of preterm birth trends is published in the journal The Lancet