Global Death Toll: One Million Premature Babies Every Year

Full Extent of the Prematurity Crisis Still Unknown, March of Dimes Says

WHITE PLAINS, N.Y., Oct. 4 /PRNewswire-USNewswire/ -- More than one million
infants die each year because they are born too early, according to the just
released White Paper, The Global and Regional Toll of Preterm Birth.

The new White Paper shows that in 2005, an estimated 13 million babies
worldwide were born preterm -- defined as birth at less than 37 full weeks of
gestation. That is almost 10 percent of total births worldwide. About one
million deaths in the first month of life (or 28 percent of total newborn
deaths) are attributable to preterm birth.

According to the White Paper, the highest preterm birth rates in the world are
found in Africa, followed by North America (United States and Canada
combined).

These data are being presented at the 4th International Conference on Birth
Defects and Disabilities in the Developing World to be held in early October
in New Delhi, India.

"Premature births are an enormous global problem that is exacting a huge toll
emotionally, physically, and financially on families, medical systems and
economies," says Dr. Jennifer L. Howse, president of the March of Dimes. "In
the United States alone, the annual cost of caring for preterm babies and
their associated health problems tops $26 billion annually.

"If world leaders are serious about reaching the United Nation's Millennium
Development Goals to reduce child mortality and improve maternal health, then
strategies and funding for reducing death and disability related to preterm
birth must receive priority," Dr. Howse adds.

An Uneven Global Problem
The new White Paper uses data published recently in TheBulletin of the World
Health Organization (WHO). The March of Dimes says the WHO Bulletin figures
are conservative -- counting only singleton preterm births, for example -- and
likely underestimates the true magnitude of the worldwide crisis of preterm
birth.

Worldwide, the preterm birth rate is estimated at 9.6 percent -- representing
about 12.9 million babies. Though all countries are affected, the global
distribution is uneven: the toll of preterm birth is particularly severe for
Africa and Asia, where more than 85 percent of all preterm births occur.
Comparison of preterm birth rates across world regions finds the highest rate
in Africa -- 11.9 percent or about 4 million babies each year; followed by (in
descending order) North America, Asia, Latin America and the Caribbean,
Oceania (Australia and New Zealand combined), and Europe. See chart below for
more information.

Increase in Preterm Births
Wherever trend data are available, rates of preterm birth are increasing. For
example, the rate of preterm birth in the U.S. has increased 36 percent in the
past 25 years. Key factors contributing to this increase include a rise in
the number of pregnancies in women over age 35; the growing use of assisted
reproduction techniques, leading to an increase in the number of twin and
higher order multiple births; and the rise in the number of late preterm
births (defined as between 34 and 36 weeks gestation).

Babies who survive a preterm birth face the risk of serious lifelong health
problems including cerebral palsy, blindness, hearing loss, learning
disabilities, and other chronic conditions. Even infants born late preterm
have a greater risk of re-hospitalization, breathing problems, feeding
difficulties, temperature instability (hypothermia), jaundice and delayed
brain development.

Underlying Causes and Risk Factors
There are some known risk factors for preterm birth that can be identified
before or during pregnancy. For example, women who have already had one
preterm baby are at greater risk. Some preterm births may be preventable by
addressing known modifiable risk factors, including:

-- Nutrition and body weight;
-- Existing medical conditions such as high blood pressure and diabetes;
-- Alcohol and tobacco use, and secondhand smoke;

-- Early elective inductions and elective Cesarean delivery.

However, at present, there is no reliable way to prevent or delay preterm
birth, says Christopher P. Howson, Ph.D., vice president for Global Programs
of the March of Dimes. "While much can be done right now to reduce death and
disability from preterm birth even in low-resource settings, we need to know
more about the underlying causes of premature birth in order to develop
effective prevention strategies," he says.

The March of Dimes and the other authors of the white paper call for greater
efforts to inform health professionals, policy makers, women of childbearing
age, and others about the worldwide toll of preterm birth and opportunities
for prevention and for care of women with high-risk pregnancies and their
babies.

Preterm Births: Why Don't They Count?
Few countries currently have good health statistics and information systems or
birth surveillance registries, the authors of the white paper say, so data on
the number of preterm births and related deaths are limited at best.

"This was a first attempt to estimate the worldwide scale of the problem,"
says Mario Merialdi, M.D., of WHO's Department of Reproductive Health and
Research, one of the editors of the White Paper and an author of the study
published in The Bulletin of WHO. "As a first step, it is necessary to
improve data on the extent of the problem." He says WHO currently is improving
its database on preterm birth in order to support decision-making in this
area.

Another challenge, the authors of the white paper say, is that there is no
internationally accepted classification of preterm birth or glossary of terms.
"We need to at least adopt common definitions and agree on what is a preterm
baby," says Joy E. Lawn, MRCP, of Saving Newborn Lives/Save the Children USA.

Dr. Lawn says there also is an urgent need for more country and regional data
on the prevalence of acute and long-term health problems and impairment caused
by preterm birth.

Data gathering and research for the White Paper and the 2010 forthcoming March
of Dimes Global Report on Preterm Birth is supported by the March of Dimes,
the World Health Organization's Department of Reproductive Health and
Research, Save the Children USA, and the Partnership for Maternal, Newborn,
and Child Health, a global partnership with 260 members.

Editors of the White Paper were Dr. Howson; Dr. Lawn; Dr. Merialdi; and
Jennifer H. Requejo, Ph.D., of the Partnership for Maternal, Newborn and Child
Health and the Institute for International Programs at the Johns Hopkins
Bloomberg School of Public Health.

The March of Dimes is the leading nonprofit organization for pregnancy and
baby health. With chapters nationwide and its premier event, March for
Babies(R), the March of Dimes works to improve the health of babies by
preventing birth defects, premature birth and infant mortality. For the
latest resources and information, visit marchofdimes.com or nacersano.org.

Almost 13 Million Preterm Births Worldwide

Number of Preterm Preterm
Births Birth Rates
%

World Total 12,870,000 9.6
----------- ---------- ---
Africa 4,047,000 11.9
------ --------- ----
North America (US & Canada)* 480,000 10.6
--------------------------- ------- ----
Asia 6,907,000 9.1
---- --------- ---
Latin America & the Caribbean 933,000 8.1
----------------------------- ------- ---
Oceania (Australia/New Zealand) 20,000 6.4
--------------------------------- ------ ---
Europe 466,000 6.2
------ ------- ---

Preterm birth rates by national income category:

-- In high resource regions, 1,014,000 infants each year are born
preterm,
or 7.5 percent of total births.
-- In middle resource regions, 7,685,000 infants are born preterm, or 8.8
percent of total births.

-- In low resource regions, 4,171,000 infants are born preterm, or 12.5
percent of total births.

Sources:
Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, Rubens C, Menon
R, Van Look P. 2009. WHO systematic review on maternal mortality and
morbidity: The global burden of preterm birth. The Bulletin of the World
Health Organization.

* See also Hamilton BE, Martin JA, Ventura SJ. 2007. Births: Preliminary data
for 2007. National vital statistics reports, Web release; vol. 57 no. 12.
Hyattsville, MD: National Center for Health Statistics.

SOURCE March of Dimes

Marshall Hoffman, 703-533-3535 or 703-801-8602 (mobile),
marshall@hoffman.pr.com; for March of Dimes; or Michele Kling,
+1-914-997-4613, or +1-914-843-9487 (mobile), mkling@marchofdimes.com,
Elizabeth Lynch, +1-914-997-4286, elynch@marchofdimes.com, both of March of
Dimes