Sexual and reproductive health

New global estimates on preterm birth published

Ensuring high-quality healthcare for women and girls essential in prevention of preterm births

17 November 2018 - World Prematurity Day - New global estimates show that in 2014, approximately 10.6% of all live births globally were preterm. Published in the journal The Lancet Global Health, and co-authored by WHO and HRP staff, the study underlines the crucial need to safeguard the health and well-being of all women and girls, and their babies, throughout life – including through ensuring access to high quality and respectful healthcare services.

Woman holding her premature baby at a neonatal intensive care unit, Croatia.
Woman holding her premature baby at a neonatal intensive care unit, Croatia.
UNICEF/Kljajo

The estimates have also been published as an online interactive tool where users can view the full data set. There are options to view global, regional or national data, where available, with regional data sorted either by WHO or other agency regional groupings. The data may be viewed as a map, chart or table format and it is possible to view multiple selected regions across the three formats. Time trends 2000 - 2014 may also be viewed for selected countries.

Preterm birth worldwide

Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis

  • Access the article
    Lancet Glob Health 2018 Published online October 29, 2018 http://dx.doi.org/10.1016/S2214-109X(18)304)30451-0

WHO defines preterm birth as babies born alive before 37 weeks of pregnancy are completed. It is the leading cause of death worldwide for children below 5 years of age. While many preterm babies survive in high-income countries, in low- and middle-income countries a lack of adequate newborn care puts the lives of many preterm babies at risk.

The new estimates show that preterm births during 2014 ranged from 13·4% in North Africa to 8∙7% in Europe, though data on preterm birth in North Africa is very limited. The authors state that “Asian and sub-Saharan African countries accounted for 78·9% of livebirths and 81·1% of preterm births globally in 2014.”

Preventing preterm birth

The causes of preterm birth are complex and vary across countries and regions. There is however much that can be done to help prevent preterm births – starting with ensuring a positive pregnancy experience for women and girls.

WHO recommends key interventions to help women enjoy good health and well-being before and throughout pregnancy, such as counselling on healthy diet and optimal nutrition, as well as on preventing tobacco and substance use. In addition, WHO recommends antenatal care that includes a minimum of 8 contacts with health professionals throughout pregnancy to identify and manage other risk factors, such as infections. Better access to contraceptives and empowering women with accurate health information and access to quality services could also help reduce preterm births.

Need for more data of better quality

The authors of the study call for both more data, and data of better quality stating:

“Preterm birth remains a crucial issue in child mortality and reflects the need for improved quality of maternal and newborn care. To better understand the epidemiology of preterm birth, the quality and volume of data needs to be improved, including standardisation of definitions, measurement, monitoring and reporting.”

While the new estimates are useful in helping to improve understanding of the global burden preterm births, it is challenging to estimate the true burden of preterm birth worldwide. In many countries, civil registration vital statistics data are not available, do not report on preterm birth and are incomplete. In countries where no preterm birth data were available, regional estimates were used as a proxy.

This lack of data means it is very challenging for researchers and clinicians to know exactly how many preterm births occur each year. This in turn presents significant obstacles to people working to improve maternal and newborn health care through policy and programming interventions, as without knowing the scale of the issue, it is difficult to know how best to address it.