India had world’s highest number of preterm births in 2020: Lancet study

New Delhi: India recorded 3.02 million preterm births in 2020 — the highest worldwide — accounting for over 20 per cent of all preterm births globally, according to a study published in the The Lancet journal.

The research by authors from the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and the London School of Hygiene and Tropical Medicine, UK, showed that over 50 per cent of all preterm births in 2020 occurred in just eight countries.

India was followed by Pakistan, Nigeria, China, Ethiopia, Bangladesh, Democratic Republic of the Congo and the US, the researchers said.

The high numbers of preterm births in these countries and areas are, in part, a reflection of their large population sizes, high numbers of total births, and weaker health systems that are unable to deliver high-quality family planning, antenatal care, and childbirth services to all individuals who need them, they said.

Globally, an estimated 13.4 million babies were born early in 2020, with nearly one million dying from preterm complications, the authors said.

The data is equivalent to around 1 in 10 babies born early, before 37 weeks of pregnancy worldwide, they said.

“Since prematurity is the leading cause of death in children’s early years, there is an urgent need to strengthen both care for preterm babies as well as prevention efforts — particularly maternal health and nutrition — so as to improve childhood survival,” the authors said.

“For those who live, preterm birth also significantly increases the likelihood of suffering major illnesses, disability and developmental delays, and even chronic diseases as adults like diabetes and heart conditions,” they said.

The study derives estimates from population-based and nationally representative data to generate internationally comparable country-level estimates for 2020.

It found that India had the highest number of preterm births in 2020 — 3.02 million — accounting for over 20 per cent of all preterm births worldwide.

Although most of the high preterm birth rates occur in low-income and middle-income countries and areas, rates of 10 per cent or higher were also observed in high-income countries such as Greece and the US, according to the researchers.

In south Asia, Bangladesh had the highest rate of preterm births in 2020 (16.2 per cent), followed by Pakistan (14·4 per cent and India (13.0 per cent).

In Latin America, country-level preterm birth rates ranged from 5.8 per cent in Nicaragua to 12.8 per cent in Suriname.

As birth registration and facility-based deliveries have increased, data on the prevalence of preterm birth has improved. Gaps remain, however, with 92 countries lacking adequate nationally representative data.

The authors are calling for continued commitment to strengthen data availability and quality, as well as data sharing so that appropriate support and action can be targeted where needed most.

“Preterm babies are especially vulnerable to life-threatening health complications and they need special care and attention,” said Dr. Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Ageing at WHO.

“These numbers show an urgent need for serious investment in services available to support them and their families as well as a greater focus on prevention — in particular, ensuring access to quality health care before and during every pregnancy,” Banerjee said.

The researchers noted that preterm birth is not just an issue in low and middle-income countries, however, and the data shows clearly that it affects families in all parts of the world.

Rates of 10 per cent or higher occur in some high-income countries such as Greece (11.6 per cent) and the US (10 per cent), they added.