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Every fourth baby in the world is born too small or born too soon – researchers present methods for improving the situation

Published on 9.5.2023
Tampere University
Vastasyntyneen vauvan käsi pitelee aikuisen sormesta.
One in four babies in the world is born preterm or small for gestational age. This is a problem that greatly affects low-income and middle-income countries. Researchers have now found eight low-cost and easily implementable proven interventions to improve the situation.

Of the 135 million babies born alive in 2020, one in four (35.3 million) were born preterm or small for gestational age. The majority of these babies were born in Sub-Saharan Africa and Southern Asia.

Interventions particularly in 81 low- and middle-income countries (LMICs) could prevent an estimated 566,000 stillbirths and 5.2 million babies a year from being born preterm or small for gestational age.

An international group of researchers led by Professor of Paediatrics Per Ashorn at Tampere University has published a new series of articles in the prestigious medical journal The Lancet.

The series presents eight antenatal clinics pregnancy interventions to support the health of pregnant women:

  • micronutrient and vitamin tablet supplement to pregnant mothers
  • treatment of asymptomatic bacteriuria
  • screening and treatment of syphilis
  • education for smoking cessation
  • balanced protein energy supplements for malnourished mothers
  • malaria prevention by malaria nets and medical means (in regions with malaria)
  • low dose aspirin treatment for mothers at increased risk of preterm delivery
  • progesterone therapy for mothers at increased risk of preterm delivery

In addition, the article presents two interventions that may reduce the mortality of preterm born children and other problems: antenatal corticosteroid therapy for the mother and delayed cord clamping of the child born. Together, these ten interventions have the potential to prevent up to 476,000 new-born baby deaths every year.

The Series estimates the cost of implementing these interventions at $1.1 billion a year.

We need national actors with global partners

The authors highlight that progress for reducing preterm birth and low birthweight is a flat line and off track of targets.

The Global Nutrition Target by the World Health Organization, for example, calls for 30% reduction of babies with low birthweight by 2030 from a 2012 baseline. However, the estimated annual rate of reduction is only 0.59%.

In the series, researchers argue for a higher quality of care for women during pregnancy and at birth, and specifically for the scale-up of pregnancy interventions in LMICs.

“Despite several global commitments and targets, every fourth baby in the world is 'born too small' or 'born too soon'. We already have the knowledge to reverse the current trend,” says Per Ashorn, Professor of Paediatrics at the Faculty of Medicine and Health Technology at Tampere University.

“A significant reduction in the proportion of preterm births and babies with low birthweight would cost about $1.1 billion a year, a fraction of what other health programmes receive. We need national actors, with global partners, to urgently prioritise action, advocate and invest,” Ashorn points out.

”Series on small vulnerable new-borns”

The Series on small vulnerable new-borns published in The Lancet is a new five-paper series that examines the birth of babies born preterm or small for gestational age and proven interventions that, if fully implemented, would improve the survival and health of small, vulnerable babies. In addition to new-borns, the interventions also benefit mothers and society more widely.

The series of articles will be published on Tuesday 9 May in The Lancet in London and launched in Cape Town, South Africa.

The articles were written by 55 researchers from over 20 universities around the world.

Contact person:

Professor Per Ashorn, per.ashorn [at], tel. +358 40 7280 354

The Lancet Series on Small Vulnerable Newborns

Small vulnerable newborns (The Lancet)