Bradley Ellen, Blencowe Hannah, Moller Ann-Beth, Okwaraji Yemisrach B, Sadler Francesca, Gruending Anna, Moran Allisyn C, Requejo Jennifer, Ohuma Eric O, Lawn Joy E
Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Reprod Health. 2025 Jun 23;22(Suppl 2):105. doi: 10.1186/s12978-025-02033-x.
There has been no measurable change in global preterm birth rates in the past decade, in any region. A handful of countries have reduced their preterm birth rates, but only marginally (0.5 percentage points annually), and there has been little progress in availability of preterm birth data globally. An estimated 13.4 million (95% credible interval (CrI): [12.3, 15.2 million]) newborns were preterm or "born too soon" in 2020, 9.9% (95% CrI: [9.1, 11.2%]) of births worldwide. Preterm birth complications remained the top cause of under-5 child mortality globally in 2022, accounting for about 1 million neonatal deaths, similar to figures a decade ago. More encouragingly, some countries have improved data systems to better capture preterm birth information and advancements have been made in gestational age measurement, highlighting targeted efforts towards improving data for action. This paper is part of a series based on the report "Born too soon: decade of action on preterm birth".
Preventing preterm birth is a critical priority and could be accelerated by focusing on context-specific risk factors, and addressing spontaneous and provider-initiated preterm births, including non-medically indicated caesarean sections. Effective care can prevent 900 000 deaths from complications of preterm birth, particularly among those born before 32 weeks' gestation. Stillbirths should be included in data, policies and programmes relating to preterm birth. Most stillbirths occur preterm (an estimated 74.3%) and have a profound, long-lasting impact on families. Addressing stillbirths is essential for reducing the overall burden of preterm birth and minimising loss of human capital.
It is important that the data are available and of high quality, plus are used to drive action. We focus on three pivots to improve in the next decade: (1) counting every baby everywhere, including those stillborn, and accurately recording gestational age and birthweight; (2) strengthening national data systems to improve the availability of individual-level data for action, including quality improvement in maternity wards and small and sick newborn care units, plus follow-up for long-term health outcomes including disabilities; and (3) using data to strengthen shared accountability at all levels, from the community to global levels.
在过去十年中，全球任何地区的早产率均未出现可衡量的变化。少数国家降低了早产率，但降幅甚微（每年0.5个百分点），而且全球早产数据的可得性几乎没有进展。2020年，估计有1340万（95%可信区间[1230万，1520万]）新生儿早产或“出生过早”，占全球出生人口的9.9%（95%可信区间[9.1%，11.2%]）。早产并发症在2022年仍是全球5岁以下儿童死亡的首要原因，约导致100万新生儿死亡，与十年前的数据相近。更令人鼓舞的是，一些国家改进了数据系统，以更好地收集早产信息，并且在胎龄测量方面取得了进展，凸显了为改善用于采取行动的数据所做的针对性努力。本文是基于《出生过早：早产行动十年》报告的系列文章之一。
预防早产是一项关键优先事项，通过关注特定背景下的风险因素以及解决自发性早产和医护人员引发的早产问题（包括非医学指征的剖宫产），可以加快预防进程。有效的护理可以预防90万例因早产并发症导致的死亡，尤其是在妊娠32周前出生的婴儿中。死产情况应纳入与早产相关的数据、政策和方案中。大多数死产发生在早产阶段（估计占74.3%），并对家庭产生深远、持久的影响。解决死产问题对于减轻早产的总体负担和减少人力资本损失至关重要。
重要的是要有可得且高质量的数据，并用于推动行动。我们关注未来十年需要改进的三个关键要点：（1）统计各地的每一个婴儿，包括死产婴儿，并准确记录胎龄和出生体重；（2）加强国家数据系统，以提高用于采取行动的个体层面数据的可得性，包括改善产科病房以及小型和患病新生儿护理单位的质量，以及对包括残疾在内的长期健康结果进行随访；（3）利用数据加强从社区到全球各级的共同问责制。
