Explainers
India among top 5 countries with babies 'born too soon'. What causes preterm births and how is this harmful?
Preterm birth problems are one of the biggest causes of mortality among children. As per a UN report, India is among the top five countries with the highest rates of preterm births in 2020, with an estimated 13 per cent. Other countries on the list were Bangladesh, Malawi, Pakistan, and South Africa
FP Explainers May 10, 2023 11:44:57 IST 
Preterm birth complications are the leading cause of child mortality. Pixabay
Of every 10 babies born, one is “born too soon.” Every 40 seconds, one of those babies dies.
Preterm birth problems remain the biggest cause of mortality among children under the age of five, accounting for more than one million newborn deaths globally in 2021, according to a recent report released by the United Nations (UN), and other agencies.
Preterm is defined as babies born before the 37th week of pregnancy.
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According to the Born Too Soon: Decade of Action on Pre-term Birth report, which was published on Tuesday, only five nations—India, Pakistan, Nigeria, China, and Ethiopia—accounted for nearly half (45%) of all preterm births in 2020.
This suggests that there is a “silent emergency” to save children’s lives.
What does the report say?
The report estimates that 13.4 million preterm births occurred in 2020, with roughly one million of those deaths being related to complications. This equates to around one in ten infant deaths.
Global estimates place Bangladesh first in terms of preterm birth rates (16.2 per cent), followed by Malawi (14.5 per cent) and Pakistan (14.4 per cent).
While South Africa and India were among the top five nations with the highest rates of preterm births, with an estimated 13 per cent each.
If we look at the total pre-term births across the five countries, India tops the list with 30.16 lakh births, followed by Pakistan with 9.14 lakh, Nigeria with 7.74 lakh, and China with 7.52 lakh.
This means India accounts for over 23 per cent of all preterm births worldwide, while Pakistan, Nigeria and China each have more than three quarters of a million preterm babies in 2020.
The high numbers of preterm births in these countries reflect not only their high numbers of total births but also higher preterm birth rates.
Moreover, the countries with the lowest preterm rates were Serbia (4.1 per cent) and Moldova (five per cent). In countries with higher income, the preterm rates persist with Greece (11.6 per cent), and the United States (10 per cent).
The 10 nations that saw the fastest declines in preterm birth rates among those with reliable time series data were: Czechia, Austria, Brunei Darussalam, Singapore, Spain, the Netherlands, Denmark, Hungary, Brazil, and Sweden.
Between 2010 and 2020, preterm birth rates decreased in all of these nations by more than five per cent, although this translates to an annual average decline of only approximately 0.5 per cent.
Preterm rates increased by more than five per cent in 13 nations — Poland, Iceland, Croatia, United Kingdom of Great Britain and Northern Ireland, Bulgaria, Armenia, Bahrain, Ireland, Chile, Georgia, Colombia, Republic of Korea, and North Macedonia — though some of these increases may be related to better data quality.
Also read: World health day 2019: is india’s healthcare system failing premature babies?
What causes pre-term birth?
According to the report, preterm birth complications are the leading cause of child mortality.
It occurs for a variety of reasons such as multiple pregnancies, infections, and chronic conditions such as diabetes and high blood pressure.
WHO notes that most preterm births happen spontaneously, however, some are due to medical reasons like infections or other pregnancy complications that require early induction of labour or caesarean birth.
There could also be a genetic influence.
In India, in order to prevent preterm births occur frequently due to a lack of access to health care services.
Dr Surender Singh Bisht, secretary general of the National Neonatology Forum (NNF) told Indian Express, “In rural areas, there used to be a common complaint of lack of access to health care but initiatives like special newborn care units, improved labour rooms and efficient deliveries have helped save many pre-term babies. But they are still not as expansive.”
How can it be prevented?
Preventing preterm birth is crucial.
It could be accelerated by focusing on context-specific risk factors and addressing spontaneous and provider-initiated preterm births, such as non-medically indicated caesarean sections.
WHO guidelines to prevent preterm birth include counselling on a healthy diet, optimal nutrition, and tobacco and substance use; fetal measurements including use of early ultrasound to help determine gestational age and detect multiple pregnancies.
In order to prevent preterm births in India, the government has launched schemes like the India Newborn Action Plan, Rashtriya Bal Suraksha Karyakram, Janani Suraksha Yojana, and more.
With inputs from agencies
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