World Prematurity Day: Harnessing Science to Address Preterm Birth

Photo courtesy of Paul Joseph Brown/GAPPS
Photo courtesy of Paul Joseph Brown/GAPPS

When you see pictures of tiny preterm babies, you likely marvel at how they fit in the palm of a hand, or how a wedding ring can slide up their arm and reach their elbow. What you may not consider is the lifelong toll premature birth can have on a person – if they survive it at all.

New research shows that for the first time ever, preterm birth is now the leading cause of death for all children under age 5 around the world.

More than 15 million babies are born too soon every year, and nearly one million of them don’t survive infancy. Those who do survive are often faced with lasting health issues such as cerebral palsy, developmental delays, or respiratory, vision and hearing problems. The burden is magnified in many developing countries, where world-class neonatal intensive care units, let alone a basic level of healthcare, are not available.

Dr. Craig Rubens, executive director of the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s, says a larger, coordinated research effort is critical to lowering the number of babies born preterm.

“It’s easy to look at preterm birth and view it as a single endpoint,” Rubens said. “In reality, preterm birth can have many causes and pathways. Although the end result is the same, we need more research to understand the different pathways so we can develop ways to prevent them.”

In conjunction with World Prematurity Day today, Rubens and his team have published a state-of-the-art review in Science Translational Medicine, providing a central analysis of preterm birth research. The findings, Rubens said, leave a lot to be desired.

“There are not enough resources dedicated to researching the complex problem of preterm birth and its prevention,” he said. “Our paper is a clarion call to the scientific community, that investing in preterm birth research will pay dividends with millions of lives saved and also save billions of dollars in healthcare expenses associated with preterm birth.”

In 2007, the Institute of Medicine estimated the annual costs associated with preterm birth to be $26 billion in the U.S. alone, and those numbers have surely increased since.

In the paper, Rubens and his co-authors note that there are many factors that can increase a woman’s likelihood of preterm birth – including genetics, stress and poor pregnancy weight gain – however, there is very little known about why those factors increase risk and what can be done to prevent them.

There are also discrepancies in preterm birth rates that are poorly understood. For example, in the United States, babies of non-Hispanic black women have preterm birth rates that are 40% greater than those of Hispanic and non-Hispanic white women, and this difference persists even after adjustment for maternal socioeconomic status and education. Unfortunately, even less is understood about the risk factors, disparities and causes of preterm birth in high-burden, low-resource countries.

Despite the sobering statistics, Rubens is optimistic that preterm birth will be recognized as a global issue that needs to be prioritized.

“As more people learn that preterm birth is the leading cause of death for children under age 5 around the world – and that it happens to moms and babies from the U.S. to Uganda – we are hopeful that scientists, policymakers and funders will prioritize preterm birth research so that every birth can be a healthy birth.”