Pre-term births and a silent emergency

India accounts for the highest number of ‘born too soon’ children

The latest version of the World Health Organisations’ (WHO) report on pre-term births, ‘Born too Soon: Decade of Action on Pre-Term Birth’. sounds a warning about a ‘silent emergency’ that has serious implications for the health of children the world over. The incidence of pre-term births has not been fully recognised for its scale and severity and is an important factor that influences children’s health and survival in their early years. The report finds that pre-term birth rates have not changed in any region in the world in the past decade, with 152 million vulnerable babies born too soon from 2010 to 2020. It is the leading cause of child mortality and accounts for more than one in five of all deaths of children occurring under five years of age. Pre-term survivors can face lifelong health problems, and have an increased likelihood of disability and developmental delays.

The report says that the rate of pre-term births has an impact on women, families, societies and economies. Only one in 10 extremely pre-term babies (born under 28 weeks) survive in low-income countries, compared to more than nine in 10 in high-income countries. Inequalities related to race, ethnicity, income and access to quality care determine the likelihood of pre-term birth, death, and disability, even in high-income countries. South Asia and sub-Saharan Africa account for more than 65% of global pre-term births. Climate change, environmental damage, air and water pollution, Covid-19, rising living costs and conflicts pose increasing risks for women and babies everywhere. Maternal health, adolescent pregnancy, lack of access to sexual and reproductive health care and absence of obstetric and general health care are important causes of pre-term births. Child delivery takes place at home without medical aid in large numbers.

India has the dubious distinction of accounting for the highest number of pre-term births at 3.02 million, which is 23% of all such births. The highest pre-term birth rate of 16.5% is in Bangladesh but India has the fourth rank with 13.5%. Provision of affordable and easily accessible health care, nutritional support to expectant mothers and improving the number of doctors, nurses and other health care personnel are necessary to prevent pre-term deliveries. Focus on girls’ education and women’s employment in both organised and unorganised sectors and creating better awareness about the risks of pre-term birth and women’s health during pregnancy will help. The report has prescribed a comprehensive agenda of action which should help governments, health care authorities and community organisations to address the problem.