Preterm birth rate drops in just 3 countries over past 20 years

Nearly 15 million babies were born prematurely in 2010—more than one in ten of all births. Sixty percent of these premature babies were born in south Asia and sub-Saharan Africa, but this is not just a problem of the poorest nations: the USA (517 000 preterm births) and Brazil (279 300) ranked in the top ten countries with the highest number of premature births in 2010. Worse still, over the past 20 years preterm birth rates have decreased in just three countries, according to the first ever national level estimates and time series published in this week's Lancet.

"Our estimates highlight a fact that has received little attention. Most European countries have about half the preterm birth rate of the USA, but whilst the US rate has levelled off, European rates, even in Scandinavian countries, are increasing",* explains Joy Lawn from Save the Children in South Africa, who led the team producing the estimates for the World Health Organisation, published in the report Born Too Soon.

Preterm birth (before 37 weeks gestation) remains the single biggest cause of neonatal death worldwide and is now the second most common cause of death in children under 5, responsible for 1.1 million deaths every year.

In this study, Lawn and colleagues used data from a number of sources including National Registries and Reproductive Health Surveys, and employed statistical modelling to assess data for 184 countries to estimate preterm birth rates for 2010 by country, region, and globally. They also calculated time trends since 1990 for 65 countries which had reliable data in developed regions, Latin America, and the Caribbean.

Numbers of premature births increased in most of the 65 countries. Only in Croatia, Ecuador, and Estonia did the preterm birth rate decrease between 1990 and 2010, whilst in 14 other countries the rate remained stable (less than 0.5% annual change).

The average rate in the 65 countries increased from 7.5% in 1990 (total preterm births 2 million) to 8.6% in 2010 (total preterm births 2.2 million).

The European countries with the greatest average increase in rates per year since 1990 were Cyprus (2.8%); Slovenia (2.6%); Belgium (2.5%); Austria (2.3%); Spain (2.2%); Ireland (2.1%); Portugal (1.9%); Greece (1.9%), France (1.6%), the UK (1.5%), and Bosnia (1.5%). By contrast, the USA had an average annual increase of just 0.7%.

The authors conclude: "The countries with the fastest increases include many European countries, and in many cases the reasons are not clear although the effects on families and the health system are very apparent. Urgent attention is needed to better understand and reduce these rates of preterm birth. At the same time we are very clear what can be done to save the lives of babies born preterm and urgent action to provide feasible, lifesaving care in African and South Asian countries would result in rapid decreases in deaths."*

In a linked Comment, Nils-Halvdan Morken from University of Bergen and Haukeland University Hospital in Norway discusses the economic burden from preterm birth: "In the USA, the Institute of Medicine estimated that preterm birth costs the country at least US$26.2 billion a year or $51 600 per preterm infant. This group of infants accounts for 12% of US livebirths per year, but their care consumes close to 60% (or $6 billion) of total spending on initial neonatal care. The expenses are clearly related to gestational age; an infant born at 38 weeks incurs a tenth of the expense of one born at 35 weeks ($441 vs $4733). Therefore, even a modest reduction in would lead to substantially reduced costs."

He adds: "Worldwide investment in maternal health and pregnancy will reduce suffering and probably save life years at a scale never before seen in the history of public health."

More information: www.thelancet.com/journals/lan… (12)60820-4/abstract

add to favorites email to friend print save as pdf

Related Stories

Preterm birth rate drops

Mar 18, 2009

The nation's preterm birth rate declined slightly in 2007 - a finding that the March of Dimes hopes will prove to be the start of a new trend in improved maternal and infant health.

Preterm births rise 36 percent since early 1980s

Jan 07, 2009

New government statistics confirm that the decades-long rise in the United States preterm birth rate continues, putting more infants than ever at increased risk of death and disability.

Recommended for you

Eating disorders linked to adverse perinatal outcomes

Oct 22, 2014

(HealthDay)—Maternal eating disorders are associated with adverse pregnancy, obstetric, and perinatal health outcomes, according to a study published in the October issue of the American Journal of Obstetrics & ...

Large variation in cesarean rates across US hospitals

Oct 21, 2014

Cesarean delivery is the most common inpatient surgery in the United States. US cesarean rates increased from 20.7% in 1996 to 32.9% in 2009 but have since stabilized, with 1.3 million American women having had a cesarean ...

User comments