152 million babies born preterm in the last decade

15 Jun 2023
bebe prematuro piel con piel con la mamá en sala de hospital
15 Jun 2023

Montevideo, June 15, 2023. Of every 10 babies born, 1 is preterm – and every 40 seconds, 1 of those babies dies. Preterm birth rates have not changed in the past decade in any region of the world. The impacts of conflict, climate change, COVID-19 are increasing risks for women and babies everywhere. 

These are some of the data that emerge from the second edition of the publication Born too soon: decade of action on preterm birth, which includes contributions from experts from WHO/PAHO, UNICEF, and the March of Dimes, among other institutions.

The report includes updated estimates from WHO and UNICEF, prepared with the London School of Hygiene and Tropical Medicine, on the prevalence of preterm births. Overall, it finds that preterm 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.

Watch the press conference on report launch

  • Of every 10 babies born, 1 is preterm – and every 40 seconds, 1 of those babies dies
  • Preterm birth rates have not changed in the past decade in any region of the world
  • The impacts of conflict, climate change, COVID-19 are increasing risks for women and babies everywhere
  • Action is needed urgently to improve the prevention of preterm birth, alongside better care for affected babies and their families

An estimated 13.4 million babies were born pre-term in 2020, with nearly 1 million dying from preterm complications, according to a new report released by United Nations agencies and partners today. This is equivalent to around 1 in 10 babies born early (before 37 weeks of pregnancy) worldwide.

Born too soon: decade of action on preterm birth, produced by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) together with PMNCH -- the world’s largest alliance for women, children, and adolescents, sounds the alarm on a “silent emergency” of preterm birth, long under-recognized in its scale and severity, which is impeding progress in improving children’s health and survival.

The report includes updated estimates from WHO and UNICEF, prepared with the London School of Hygiene and Tropical Medicine, on the prevalence of preterm births. Overall, it finds that preterm 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.

Preterm birth is now the leading cause of child deaths, accounting for more than 1 in 5 of all deaths of children occurring before their 5th birthday. Preterm survivors can face lifelong health consequences, with an increased likelihood of disability and developmental delays.

In this context, urgent action is needed to improve the prevention of preterm births, as well as to improve care for affected babies and families.

In addition, the report notes that, too often, where babies are born determines if they survive. The report notes that only 1 in 10 extremely preterm babies (<28 weeks) survive in low-income countries, compared to more than 9 in 10 in high-income countries. Gaping inequalities related to race, ethnicity, income, and access to quality care determine the likelihood of preterm birth, death, and disability, even in high-income countries.

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

The Perinatal Health Advisor of the Latin American Centre for Perinatology - Women's and Reproductive Health (CLP/WR), Pablo Durán, recalled that in the Americas region, about 1 in 10 babies born is premature. This represents more than one million newborns every year.

The report also highlights that the impacts of conflict, climate change and environmental damage, COVID-19, and rising living costs are increasing risks for women and babies everywhere. For example, air pollution is estimated to contribute to 6 million preterm births each year. 

Maternal health risks, such as adolescent pregnancy and pre-eclampsia, are closely linked to preterm births. This underlines the need to ensure access to sexual and reproductive health services, including effective family planning, with high-quality care in pregnancy and around the time of birth.

"The consequences of prematurity are well known. Also in our region, complications of prematurity are the leading cause of infant death and represent the main contributor to the burden of disease and disability in childhood. That is why the prevention of prematurity must be the first objective to reduce the frequency of premature births," said the CLP/WR advisor, who also pointed out that "Unfortunately this [preventing preterm births] is not always possible, so it is also necessary to have clear strategies to deal with the possible complications that may arise, in order to ensure the optimal development and wellbeing of both babies and their families.

The director of CLP/WR, Suzanne Serruya, stated that “This is an extremely important issue for the center. In the region we still have a lot to improve in relation to the health of the newborn and, without a doubt, the correct approach to prematurity is a key element”. She also pointed out that there are important regional inputs and guidelines with evidence-based information on the strategies that should be developed and invited countries to take ownership of these recommendations to improve their indicators.

Actions proposed by Born too soon
  • Increased investments: Mobilizing international and domestic resources to optimize maternal and newborn health, ensuring high quality care is provided when and where it is needed.
  • Accelerated implementation: Meeting country targets for progress through implementing established national policies for maternal and newborn care.
  • Integration across sectors: Promoting education through the life cycle; supporting smarter economic investments, with co-financing across sectors; strengthening climate adaptation responses across the life-course; and advancing the coordination and resilience of emergency systems.
  • Locally driven innovation: Investing in locally led innovation and research to support improvements in quality of care and equity in access.
Family groups involved and leading processes

The last decade has also seen the growth of community activism around the prevention of preterm birth and stillbirth, driven by networks of families, health professionals, academia, civil society and others. Around the world, groups of families affected by preterm birth have been at the forefront of advocating for access to better care and policy change, as well as support for other families.

Experiences also exist in the region. In fact, CLP/WR has been working on a network of organisations of families of preterm babies, which currently has 21 groups in 15 countries in the region.

For Durán, the involvement of families is fundamental and is a perspective that all health centres that care for newborns should incorporate. "Families are a crucial part of care. They must be accompanied, informed and, above all, their needs must be heard in order to make real progress in quality care that puts the newborn, their family and their community at the centre".