High Number of Premature Births Cause for Concern

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Worldwide, the number of premature births is estimated at 9.6 percent, which represents nearly 13 million babies who are born at less than 37 full weeks of gestation. Of these 13 million infants, more than one million die each year because they were born too early, according to a just-released White Paper, “The Global and Regional Toll of Preterm Birth,” a joint effort of the March of Dimes and other health organizations, and which includes data from the Bulletin of the World Health Organization (WHO).

Together Africa and Asia have the highest percentage of premature births - more than 85 percent of the nearly 13 million. More than 4 million infants are born prematurely in Africa, while Asia has nearly 7 million. While the total number of premature births in North America (includes both the United States and Canada) is comparatively low at 480,000, the two highly industrialized countries come in second to Africa with a 10.6 percent premature birth rate. Latin America and the Caribbean register a rate of 8.1 percent, Australia and New Zealand at 6.4 percent, and Europe at 6.2 percent.

Premature births have an enormous impact on the emotional, financial, and physical welfare of families, as well as a tremendous toll on the medical facilities and systems in the respective countries. According to the White Paper, the cost per year of caring for premature infants in the United States alone is greater than $26 billion.

Although the number of premature births and premature infant deaths are high, the March of Dimes notes that they are likely even higher because the WHO data probably underestimated the depth of the problem by counting singleton preterm births only, for example. Perhaps more important at this point than the actual figures is understanding why the number of premature birth is so high, why premature infants are dying, and what can be done to reduce these rates.

The White Paper, for example, reports that number of premature births in the United States has increased 36 percent in the past quarter century. Factors contributing to this increase include the rising number of women who are using fertility drugs and other reproduction aids and a rise in the number of women older than 35 who are giving birth (older women are more likely to give birth prematurely). According to the March of Dimes, many cases of premature birth are caused by the body’s natural response to infections, and about 25 percent of preterm birth are the result of health problems in the mother or the fetus. In some cases, the reason is never known.

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Some known risk factors for premature birth include:

* Having given birth to a premature infant in the past
* Pregnant woman has an existing medical condition such as diabetes or high blood pressure
* Use of alcohol, illegal drugs, and/or tobacco by the expectant mother
* Lack of prenatal care
* Pregnant woman is underweight or obese
* Presence of birth defects
* Extremely high levels of stress

Infants who are born prematurely and who survive are at high risk of experiencing lifelong health problems including brain injury, blindness, hearing loss, learning disabilities, chronic lung disease, and other chronic conditions. Other risks include breathing difficulties (e.g., respiratory distress syndrome), pneumonia, jaundice, immature gastrointestinal tract, anemia, an inability to maintain proper body temperature, and delayed brain development.

The authors of the White Paper note that this report was the first attempt to identify the scope of premature births and related infant deaths. Because many countries do not have reliable statistics on birth numbers and associated information, it is still difficult to get an accurate idea of the magnitude of the problem. The World Health Organization is currently working to improve its database on premature birth rates to support further research efforts.

SOURCES:
March of Dimes

Bulletin of the World Health Organization

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