PUBLISHED: 15:23 EST, 3 May 2012 | UPDATED: 16:00 EST, 3 May 2012
The first-ever country-by-country estimate of premature births has found that about 12 per cent, or 500,000, of all babies in the United States are born before due date, a rate far higher than in Europe, Canada, Australia or Japan.
The study ‘Born Too Soon: The Global Action Report on Preterm Birth’ that was released on Wednesday ranked the US 131st out of 184 countries — between the Congo and Nigeria, and tied with Somalia and Thailand.
According to the report, 15 million babies a year are born prematurely worldwide, which amounts to more than 1 in 10 live births. In the US, that rate stands at about 1 in 8 live births, which is almost twice as high as in Sweden.
About a million of those babies die shortly after birth, and countless others suffer severe, life-long physical disorders like cerebral palsy and blindness, as well as learning disabilities, the report states.
Joy Lawn, the director of global evidence and policy for Save the Children and co-editor of the report, said that the study dispels the notion that premature births are rare.
‘Being born too soon is an unrecognized killer,’ she said.
COUNTRIES WITH HIGHEST NUMBER OF PRETERM BIRTHS
1. India – 3,519,100
2. China – 1,172,300
3. Nigeria – 773,600
4. Pakistan – 748,100
5. Indonesia – 675,700
6. United States of America – 517,400
7. Bangladesh – 424,100
8. Philippines – 348,900
9. Dem. Republic of Congo – 341,400
10. Brazil – 279,300
The report was compiled with the help of the World Health Organization (WHO) and the Partnership for Maternal, Newborn and Child Health, a non-profit education and advocacy group.
For the report, preterm was defined as 37 weeks of completed gestation or less, the standard WHO definition. Most preemies fall in the ‘late preterm’ category, born between 32 and 37 weeks. Extreme preemies are born before 28 weeks.
While more than 60 per cent of preterm births are in the underdeveloped areas of sub-Saharan Africa and South Asia, they are also a problem for some high-income countries, including the US and Brazil.
Among the factors driving up the rate of preterm births in the US is the number of older women having babies; increased use of fertility drugs; obesity; and increased rates of medically unnecessary Caesarean deliveries, the study says.
In addition to a notable age gap, with more preterm babies born to women younger than 17 and older than 40, there is also a racial gap in the US, according to Christopher Howson, a co-editor of the report.
In 2009, the preterm birthrate for African-Americans was as high as 17.5 per cent, compared with 10.9 per cent for Caucasians.
‘We need to do a lot more to prevent preterm births, such as improving health care access for all, bringing down rates of smoking and issues of unnecessary C-sections and inductions,’ Howson said.
However, unlike in many other countries with high preterm rates, most American women have access to state-of-the-art hospital equipment and sophisticated intensive care that is capable of saving the majority of premature babies, even the tiniest ones.
‘If you’re in the States and have a preterm baby now, even at 25 weeks you’ve got a 50 per cent chance of survival and people expect that.
‘Whereas in Ghana, if a baby’s born two months early, people kind of expect the baby to die,’ Lawn said.
In fact, the risk of death from emerging into the world too soon is at least 12 times higher for an African newborn than for a European baby, the report found.
The Associated Press reports that nearly 450,000 tiny lives could be saved if in the course of labor the mother is provided with a $1 steroid shot that would hasten the development of immature fetal lungs. Other measures that are needed in developing countries include antibiotics and antiseptic cream.
Globally, preterm births are the second-leading killer of children younger than five behind pneumonia, and Lawn says the numbers are on the rise. Out of 65 countries where reliable trend data is available, only Croatia, Ecuador and Estonia show a significant reduction from 1990 to 2010.
However, at 4 per cent, it is Belarus that leads the world with the lowest rate of preterm births.
Reuters has reported that the Bill & Melinda Gates Foundation has committed $1.5 billion over four years to support interventions such as antenatal corticosteroids and to discover new ones. The organization the March of Dimes is spending $20 million a year for research on the causes of prematurity and to improve access to prenatal care.
The WHO and its partners have set two goals for 2025: eliminating mortality from preterm births in countries where the rate of preterm birth is now less than 5 per cent, and cutting mortality by half where it is 5 per cent or more.