India contributed 20 per cent of all preterm births (3·02 million), the highest in the world followed by Pakistan, Nigeria, China, Ethiopia, Bangladesh, the Democratic Republic of the Congo, and the US, according to a study published in The Lancet.
A preterm birth is defined as a baby who is born before the 37th week of gestation, as opposed to the normal term of 40 weeks. Preterm births have a higher chance of neonatal mortality (children dying within one month of birth).
The analysis revealed that India has not shown any improvement in reducing preterm or premature births in the previous decade, a trend which was in contrast with the improvements that the country has made in other maternal and child mortality indicators over the same time period.
The paper analysed preterm births in 2020 across 194 countries and compared them with trends from 2010. It found that the preterm birth rate - i.e., the number of births that took place prematurely every 1000 live births - was 13.0 in 2020, almost identical to the rate of 13.1 in 2010.
However, the authors said that these absolute numbers must be interpreted with few caveats, two being the reflection of large population sizes and the high number of total births happening in these countries. The authors of the paper added that these high numbers of preterm births were also reflective of “weaker health systems that are unable to deliver high-quality family planning, antenatal care, and childbirth services to all individuals who need them”.
According to the National Family Health Survey (NFHS)-5 data, India has significantly reduced the neonatal mortality rate to 24.9 per 1000 live births, down from 29.5 in the previous survey. Its share of the global newborn mortality burden came down from one-third in 1990 to below a quarter now. But the country still registers the highest number of neonatal deaths across the world. While preterm births are not the only reason for neonatal deaths, they remain one of the most significant causes.
In its report ‘Born Too Soon’ released in May 2023, the WHO has noted that premature births as one of the two underlying causes of low birth weight.