Born Too Soon: Accelerating actions for prevention and care of 15 million newborns born too soon

Abstract

Preterm birth complication is the leading cause of neonatal death resulting in over one million deaths each year of the 15 million babies born preterm. To accelerate change, we provide an overview of the comprehensive strategy required, the tools available for context-specific health system implementation now, and the priorities for research and innovation. There is an urgent need for action on a dual track: (1) through strategic research to advance the prevention of preterm birth and (2) improved implementation and innovation for care of the premature neonate. We highlight evidence-based interventions along the continuum of care, noting gaps in coverage, quality, equity and implications for integration and scale up. Improved metrics are critical for both burden and tracking programmatic change. Linked to the United Nation's Every Women Every Child strategy, a target was set for 50% reduction in preterm deaths by 2025. Three analyses informed this target: historical change in high income countries, recent progress in best performing countries, and modelling of mortality reduction with high coverage of existing interventions. If universal coverage of selected interventions were to be achieved, then 84% or more than 921,000 preterm neonatal deaths could be prevented annually, with antenatal corticosteroids and Kangaroo Mother Care having the highest impact. Everyone has a role to play in reaching this target including government leaders, professionals, private sector, and of course families who are affected the most and whose voices have been critical for change in many of the countries with the most progress.DeclarationThis article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal, Newborn and Child Health and the World Health Organization (WHO). The original article was published in PDF format in the WHO Report "Born Too Soon: the global action report on preterm birth" (ISBN 978 92 4 150343 30), which involved collaboration from more than 50 organizations. The article has been reformatted for journal publication and has undergone peer review according to Reproductive Health's standard process for supplements and may feature some variations in content when compared to the original report. This co-publication makes the article available to the community in a full-text format.

Functional capacity, independence and home affordances of premature children attending daycare centers

“…Lack of parental knowledge regarding which toys are best suited to stimulate the development of their children can lead to prioritizing other goods (2,29) or purchasing unsuitable toys with little variation (6). This implicates the need for trained professionals to better guide parents as to the acquisition and use of toys, as was also suggested by Noble et al (30).…”

“…Prematurity was the only biological risk factor emphasized in this study in order to homogenize the sample since it has relevant effect in child development and is directly correlated with other risk factors such as low birth weight (27,28), the presence of associated diseases (2,28), the length of hospital stay after birth (27,28) and the need to stay on mechanical ventilation (28).…”

“…The scienti ic and technological progress of the last two decades have allowed innovations in obstetric and neonatal care favoring the realization of interventions (1) which contributed to a signi icant increase in the survival of premature infants (1,2), being prematurity a main risk factor for changes in the child development in different stages of their lives (3,4).…”

“…The intrinsic factors are inherent to the person such as low birth weight and prematurity (1,2,3,5). The extrinsic factors are external elements that act on the child since the conception and include the stimuli and opportunities generated by the environment in which the child lives such as the level of education (5,6,7) and socioeconomic status of the parents (6 -8).…”

Microbiologic and Inflammatory Markers of Periodontitis are Different to those of Preterm Birth

“…Preterm birth (PTB), defined as delivery occurring before 37 gestational weeks, is the leading cause of neonatal mortality and morbidity and also generates important medical costs [2]. In highincome countries, the prevalence of PTB increased over the last 30 years reaching a plateau in the last decade, and currently accounts for 4% to 12% of all life births [3,4].…”