WHO report: Simple measures can drastically reduce preterm births


Some relatively simple measures within prenatal and postnatal care could drastically reduce the number of preterm births in the world and provide better potential for those children born prematurely. This is the main message of a new report from the WHO and a series of other international organizations, where Professor Bo Jacobsson at the University of Gothenburg is one of the editors-in-chief.

The report Born too soon: decade of action on preterm birth is a follow-up of a highly noted report on the same theme from 2012. More than 70 organizations and 140 experts from 46 countries are behind the report. In general, the report shows that advances in preventing preterm births have stagnated in the last decade. The efforts made have been insufficient and the work to prevent preterm births has failed.

Cover of the report "Born too soon: decade of action on preterm birth"
Bo Jacobsson, professor of obstetrics and gynecology at the Institute of Clinical Sciences at the University of Gothenburg, was one of the editors-in-chief of this report.

Optimism for the future

At the same time, the report also highlights opportunities. It notes that there is reason for optimism.

“In recent years, several studies have shown that relatively simple measures can drastically reduce the number of preterm births or improve survival of premature infants,” says Professor Bo Jacobsson, who was editor-in-chief for the report together with his colleague Joy E Lawn.

One example is the increase in use of the kangaroo care, where a 2021 publication showed that mortality for children from one-kilo birth weights can be reduced by 25 percent if the newborn is cared for on the mother’s bosom. Another example is delaying the cutting of the umbilical cord, where this simple measure of waiting a bit before cutting the umbilical cord has proven beneficial for preterm infants.

Knowledge is power

Bo Jacobsson is a professor of obstetrics and gynecology at the Institute of Clinical Sciences at the University of Gothenburg and senior physician at Sahlgrenska University Hospital. His group studies mechanisms behind preterm births, including genetic factors, where the results can take many years before they have an impact on reducing preterm births.

This new report primarily focuses on simple measures that can quickly impact preterm birth rates around the world. One such measure is giving women better control over their own reproduction. Unwanted pregnancies and teenage pregnancies have been shown to have higher risk than planned pregnancies. Non-medical measures, such as the educational level of the mothers, access to clean water and sanitation, are also important.

“By focusing on education for women around the world in general, including in Sweden, we could give more women the opportunity to better understand their choices in life and thereby also gain control over their own fertility,” says Jacobsson.

The report can hopefully impact the debate on reproductive health in many countries. In recent years, for example, several countries, including Poland and the U.S., have become more restrictive to abortion, which risks increasing their number of preterm births.

Economic perspective

Another perspective to preterm births is the global inequalities in perinatal care. The country in which a child is born greatly impacts the outcome. In Sweden, 90 percent of children born in week 28 survive, but in other places only 10 percent survive. The cost of living for families is also an important perspective.

“In many countries, families were having difficulty even before the current economic crisis. When healthcare is not taxpayer funded, paying for the care needed for a child born prematurely can be insurmountable. It is an event that can ruin an entire family,” says Jacobsson.

Text: Elin Lindström

Download the report here: Born Too Soon: Decade of Action on Preterm Birth