15 Million Babies Born Too Soon; Global Preterm Birth Rate at Record High Level and Increasing, But Inexpensive Newborn Care Could Save Over 75% of 1.1 million Preterm Babies Dying Each Year

(Jakarta, Indonesia) -- Each year, over 675,000 babies in Indonesia are born too early, according to Born Too Soon: The Global Action Report on Preterm Birth, released on May 2^nd by Save the Children, The March of Dimes Foundation, The Partnership for Maternal, Newborn & Child Health and The World Health Organization.

The report, which presents the first-ever country ranking of preterm birth rates, puts Indonesia in eighth position with 15.5 preterm births per 100 births (or 1.55 in 10 births). Globally, 15 million babies – more than one in 10 births – are born too early, and over one million of them die shortly after birth.

“Preterm births account for almost half of newborn deaths in Indonesia,” said Dr Erlyn Sulistyaningsih, the Senior Health Program Manager for Save the Children in Indonesia. “Even for those that survive, many suffer from some type of lifelong physical, neurological or educational disability.”

The countries with the greatest numbers of preterm births are:

India - 3,519,100; China - 1,172,300; Nigeria - 773,600; Pakistan - 748,100; Indonesia - 675,700; United States - 517,400; Bangladesh - 424,100; Philippines - 348,900; Democratic Republic of the Congo - 341,400; and Brazil - 279,300.

The 10 countries with the highest rates of preterm births for every 100 births are:

Malawi-18.1 per 100; Comoros and Congo-16.7; Zimbabwe-16.6; Equatorial Guinea-16.5; Mozambique-16.4; Gabon-16.3; Pakistan-15.8; Indonesia-15.5; and Mauritania-15.4.

Those contrast with the 11 countries with the lowest rates of preterm births:

Belarus-4.1; Ecuador-5.1; Latvia-5.3; Finland, Croatia, and Samoa-5.5; Lithuania and Estonia-5.7; Antigua/Barbuda -5.8; Japan and Sweden-5.9.

Year on year, these numbers have been increasing. Of the 65 countries with reliable trend data for preterm birth rates, all but 3 countries have shown increases in the last 20 years.

In many low-income countries, the main causes of preterm births include infections, malaria, HIV, and high adolescent pregnancy rates. In high-income countries, the increases in the number of preterm births are linked to the number of older women having babies, increased use of fertility drugs and the resulting multiple pregnancies, and lifestyle challenges such as obesity, smoking and diabetes. Medically unnecessary inductions and Cesarean deliveries before full-term have also increased preterm births. In rich and poor countries, many preterm births remain unexplained.

But the most startling finding in the report revealed that the likelihood of preterm babies surviving is largely dependent on where they are born. In low-income countries, more than 90 percent of extremely preterm babies (younger than 28 weeks or more than 3 months early) die within the first few days of life, while less than 10 percent die in high-income countries.

“This 90: 10 survival gap means these babies are not just born too soon – they are born to die, with even their families not knowing there are highly effective solutions that could save their lives”, said Joy Lawn, M.D., PhD, co-editor of the report and Director, Global Evidence and Policy for Save the Children’s Saving Newborn Lives program, and coordinator of the team that undertook the estimates. “A number of countries, for example, Ecuador, Turkey, Oman and Sri Lanka have halved their neonatal deaths from preterm birth through improving care of serious complications like infections and respiratory distress.”

Evidence-based solutions include:

• Antenatal steroid injections for mothers in premature labor, which cost $1 per injection. This helps develop immature fetal lungs and prevent respiratory problems; yet, in low-income countries, they are currently only given to 10 percent of those in need. This alone could save almost 400,000 lives of babies a year.
• "Kangaroo Mother Care" where the newborn is held skin-to-skin on the mother's chest to keep warm, making frequent breastfeeding easy, preventing infections and provides constant maternal supervision. This could save 450,000 lives a year.
• Observe infection prevention practices closely in handling newborns, particularly washing hands and cord care.

An estimated three-quarters of those preterm babies who die could survive without expensive care if proven and inexpensive treatments and preventions were available for all babies wherever they are born.  Skilled frontline workers, especially midwives and nurses with the right skills are the most critical during the delivery of babies.  

Born Too Soon culminates with a new, globally agreed goal to half the number of babies dying from preterm birth by 2025. This can be achieved in Indonesia but requires an integrated approach to prevent the occurrence of preterm and low birth weight birth, through improving antenatal care and nutrition to women as well as the use of contraception to prevent unwanted pregnancy.  These issues should be raised for greater attention worldwide, for the voices of affected parents to be heard, and for policymakers to invest and implement policies.

Save the Children works with the government of Indonesia in addressing issues related to Low Birth weight such as promoting improved hygiene and Kangaroo Mother Care.

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Contacts for Save the Children:

• Monika Gutestam, Save the Children, +1 202 640 6713, +1 202 262 6937 (m); mgutestam@savechildren.org
• Patricia Norimarna, Save the Children in Indonesia, +62 21 7812336 Ext. 313, +62 812 1088705 (m); patricia.norimarna@savethechildren.org

Full Report: www.who.int/pmnch/media/news/2012/preterm_birth_report/en/index.html

Interactive map of preterm births: www.marchofdimes.com/borntoosoon

Commitments to preterm birth for Every Woman Every Child: www.everywomaneverychild.org/

About Save the Children

Save the Children is the world’s leading children’s rights organisation, with 28 national Save the Children offices and operational programmes in over 120 countries. We deliver immediate and lasting improvements to children’s lives worldwide.

Save the Children has worked in Indonesia with national and local government agencies, non-governmental partners, and communities since 1976. Our programme approach brings long term and sustainable benefits to Indonesian children. We work to establish effective, self-sustaining practices related to child protection, health, education, livelihoods, emergency response, and disaster risk reduction