Too little known on early birth

Posted 19/11/2012

Experts have warned that more research is needed to find out how to reduce the number of babies born early.

Prematurity is the second most common cause of death for children under five. A study of 39 developed countries suggest the number could be cut by measures such as stopping multiple IVF pregnancies, but this would only be a reduction of 5% and experts writing in the Lancet say the reason for many early births remains unknown and much more research is needed.

It is estimated that 15 million babies are born before the 37th week of pregnancy and the rates are rising almost everywhere. There is however limited understanding as to why this is happening or what could be done. An estimated 1.1 million premature babies die each year and most are born just a few weeks early in developing countries where they die from a lack of simple care. Experts believe developed countries can also cut the rates and child health experts from organisations including the World Health Organisation, Save the Children and the London School of Hygiene and Tropical Medicine looked at what could be done in the 39 most developed countries if these recognised measures were implemented:

1.    Stopping smoking;
2.    Promoting single pregnancies in IVF treatment;
3.    Reducing by 80% planned caesarean sections, which are often carried out before due dates, unless there is a medical reason;
4.    Providing progesterone supplements to women with high risk pregnancies and cervical stitches for women with a weak cervix.

If all of these were implemented, it is suggested that premature births could be prevented for 58,000 babies. At the World Prematurity Day on the 17th November, experts said the reductions which could be achieved by 2015 would vary from 8% in the US to much smaller reductions in European countries and only 2% in the UK.

A Dr Joy Lawn of Save the Children, who is part of the Born Too Soon initiative that seeks to cut prematurity rates, said: “Our analysis shows that the current potential for pre-term birth prevention is shockingly small. Our hope is that the proposed target of 5% reduction in pre-term births in high income countries will motivate immediate programme action and the 95% knowledge gap will motivate immediate strategic research. Research should also focus on pre-term birth causes and solutions in low income countries where pre-term birth rates are the highest and the underlying causes may be much simpler to address”.  

In the Lancet, Jane Norman and Andrew Shennan of Tommy’s Centre for Maternal and Fetal Health at the University of Edinburgh said: “Until considerable strides have been made in our understanding of how, why and when pre-term births occur and the effects that this has on both mother and baby, pre-term births will remain a major public health problem from which no country in the world is immune”.

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