13 million premature births worldwide, 1 million deaths

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At least 13 million infants are born prematurely each year globally and more than a million of them die, according to a new paper released today by the March of Dimes. Africa has the highest rate of premature births, at 11.9%, but the United States is close behind at 10.6%. Europe has the lowest rate at 6.2%, according to the paper, which was to be released today in New Delhi at the start of the 4th International Conference on Birth Defects and Disabilities in the Developing World.

‘This is the first report to really document the fact that the global toll is severe,’ said Christopher P. Howson, vice president for global programs at the March of Dimes. ‘We put out this report because we felt that this global crisis was an issue that is under-recognized, under-counted, undervalued and underfunded.’

‘Premature births are an enormous global problem that is exacting a huge toll emotionally, physically and financially on families, medical systems and economies,’ added Dr. Jennifer L. Howse, president of the March of Dimes. ‘In the United States alone, the annual cost of caring for preterm babies and their associated health problems tops $26 billion annually.’ The health risks of prematurity include immature organs, breathing problems, feeding problems, difficulties regulating body temperature, jaundice and a three-fold increase in death during the first year of life. Many preemies also suffer long-term neurodevelopmental problems.

The information in the report came from data originally collected by the World Health Organization, said Dr. Mario Merialdi of the WHO’s department of reproductive health and research and one of the authors. The data are conservative, he said, because they include only singleton births. Most multiple births, whether natural or from assisted reproduction, are also premature.

Researchers are not sure of all the causes of premature birth. In the United States, one cause is Cesarean sections, which are now the most common surgical procedure for women. Other causes include the increased number of pregnancies among women over age 35; assisted reproduction techniques with the implantation of multiple embryos; poor nutrition and low bodyweight; pre-existing medical conditions, such as diabetes and high blood pressure; and alcohol and tobacco use and secondhand smoke.

Unfortunately, at present there is no way to prevent or delay preterm birth. ‘As a first step, it is necessary to improve data on the problem,’ Meraldi said. ‘This is a first attempt to estimate the worldwide scale of the problem.’

-- Thomas H. Maugh II