According to a report published recently, India has the highest number of deaths due to premature births, and ranks 36th in the list of pre-term births globally. The ranking included 199 countries.

Of the 27 million babies born in India annually (2010 figure), 3.6 million are born prematurely, of which 303,600 don't survive due to complications.

Nearly half of all child mortality is due to pre-term births, a new report by Save the Children, titled ‘Born Too Soon: The Global Action Report on Pre-term Birth' has revealed. The deaths due to pre-term births are second only to pneumonia, it notes.

In terms of deaths due to pre-term birth, India is at the top (indicating it fares the worst), while in terms of the rate of pre-term births, it is ranked 36th, after Malawi (ranked first), Pakistan (ranked eighth), Nepal (20th), and Bangladesh (24th), says the report.

Each year, 15 million babies, making up more than one in 10 births globally, are born too early, says the report. More than one million of those babies die shortly after birth; countless more suffer some type of lifelong physical, neurological, or educational disability, often at great cost to families.

Save the Children India Senior Advisor for Maternal, Child and Newborn Health Dr. Rajiv Tandon said: “The problem of premature birth needs both attention and intervention if India is to improve its maternal and child health record.

An estimated three quarters of the pre-term babies who die can survive without expensive care, if a few proven and inexpensive treatments and preventions are available globally, according to more than 100 experts who contributed to the report, representing almost 40 U.N. agencies, universities, and organisations.

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.

For the report, pre-term was defined as 37 weeks of completed gestation or less, which is the standard WHO definition.

Save the Children - India CEO Thomas Chandy said many factors, such as early marriage and pregnancy, inadequate nutritional intake by pregnant women, and want of adequate health interventions were among the reasons that contributed to such a high rate of pre-term pregnancy, exposing both the mother and the baby to risk.

“All newborns are vulnerable, but pre-term babies are acutely so,” says U.N. Secretary-General Ban Ki-moon, who wrote the foreword to the report, and considers the effort to reduce pre-term births and deaths an integral part of his Global Strategy for Women's and Children's Health.

More than 60 per cent of pre-term births occur in Africa and South Asia. The 10 countries with the highest numbers include Brazil, the United States, India and Nigeria, demonstrating that pre-term birth is truly a global problem. Of the 11 countries with pre-term birth rates of more than 15 per cent, all but two are in sub-Saharan Africa. In the poorest countries, on average, 12 per cent of babies are born too soon, compared with 9 per cent in higher-income countries.

A key way to reduce pre-term numbers is to find ways to help all pregnancies continue to full term. A number of risk factors for pre-term birth have been identified, including a prior history of pre-term birth, being underweight/overweight, diabetes, hypertension, smoking, infection, maternal age (either under 17 or more than 40), genetics, multi-foetal pregnancy, and pregnancies spaced too closely together.

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