One million babies die a year after being born to soon – but no progress has been made in a decade

A pregnant woman

A pregnant woman

Every two seconds a baby is born too soon, and every 40 seconds one of those babies dies, according to new data released by the United Nations.

Despite a million babies dying every year from preterm complications, no region in the world has made any progress in reducing preterm births for a decade, it said.

Preterm births – and fatal complications – are the world’s “silent emergency”,  says the report Born Too Soon, published on Wednesday.

“Despite the many advances the world has made in the past decade, we have made no progress in reducing the number of small babies born too soon or averting the risk of their death,” said Steven Lauwerier, director of health at UNICEF. “The toll is devastating.”

Preterm birth is now the leading cause of child deaths globally, accounting for nearly one in five of under-five deaths. In the UK, preterm birth complications are the top cause of death in the first 10 years of life.

The global preterm birth rate was 9.9 per cent in 2020, compared to 9.8 per cent in 2010, with 13.4 million babies born too early in 2020 alone.

Preterm babies that survive often face lifelong health consequences, including developmental delays and an increased likelihood of permanent disability.

Health risks such as adolescent pregnancy, treatable infections like malaria and syphilis, and pre-eclampsia, are closely linked to preterm births. To reduce preterm births, the report calls for better family planning and antenatal care.

To manage preterm labour, the UN also recommended drugs such as tocolytics to slow down labour, and antibiotics for preterm premature rupture of the membranes.

Wealth and birth inequality

It has been more than a decade since the UN produced a major report on preterm births.

In the 2023 edition, the report noted vast differences between survival rates in low- and high-income countries. Over 90 per cent of extreme preterm babies (born before 28 weeks) will survive in high-income settings, compared to less than 10 per cent in low-income nations.

Southern Asia and sub-Saharan Africa have the highest rates of preterm births, and preterm babies in these regions face the highest mortality risk. Together, these two regions account for more than 65 per cent of preterm births globally.

In 2020, Bangladesh had the highest estimated preterm birth rate (16.2 per cent), followed by Malawi (14.5 per cent) and Pakistan (14. 4 per cent). Rates were also high in high-income countries, such as Greece (11.6 percent) and the United States of America (10 per cent) and Great Britain (7.2 per cent).

In 13 countries, including Great Britain, Northern Ireland and Poland the preterm rates increased by more than five per cent, although the UN said some of these increases may relate to improved data collection.

Almost half (45 per cent) of all preterm babies in 2020 were born in just five countries: India, Pakistan, Nigeria, China and Ethiopia.

Only a handful of countries have made progress in reducing their preterm birth rates, which were described as “modest” at five per cent in 10 years. Among the ten fastest were Austria, Singapore, Spain and Sweden.

The report comes a day after the WHO revealed that global progress in reducing deaths of pregnant women, mothers and babies has also flatlined, with no improvements for eight years.

The WHO said more than  4.5 million women and babies die every year during pregnancy, childbirth or the first weeks after birth – equivalent to one death every seven seconds – mostly from preventable or treatable causes.

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