Journal Article

Born Too Soon: Learning from the past to accelerate action in the next decade

Khosla, Rajat, Robb-McCord, Judith, Kak, Lily, McDougall, Lori, Kinney, Mary V., Bhutta, Zulfiqar A., Decena, Ditas Duque, Lawn, Joy E., Dube, Queen, Gruending, Anna, Jacobsson, Bo, Deorari, Ashok K., Zaka, Nabila, Banerjee, Anshu, Fogstad, Helga, Reid, Amy, Langlois, Etienne V.

2025

Overview

Progress This paper is a narrative review that takes stock of the progress in addressing preterm birth over the past decade – notably on policies, national plans, innovation, evidence, social mobilisation, and community engagement – to inform future progress on preterm birth. At the global policy level, many countries have strongly supported collective initiatives and resolutions on maternal and newborn health relevant to preterm birth in multilateral fora, most recently through a World Health Assembly resolution calling for a revival amongst the global community on stalled progress for maternal, newborn and child health. Following the adoption of other global plans, like the Every Newborn Action Plan and Strategies for Ending Preventable Maternal Mortality, most countries set corresponding national mortality and coverage targets, and many have national and subnational policies and plans for integrated maternal and newborn health. Adequate financing remains a challenge, and sexual and reproductive health and rights of women and girls are being challenged globally. There have been significant advances in evidence-based interventions for preterm birth prevention and care, reflected in updated World Health Organization guidelines on antenatal, intrapartum and postpartum care, and care for small and sick newborns. The past decade has also seen progress in social mobilisation and community engagement, particularly parent groups and healthcare professional organisations advocating on issues surrounding preterm birth. Polycrisis and vulnerability There are, however, significant challenges that continue to hamper progress on preterm birth. Polycrisis – the interplay of overlapping economic, geopolitical, and environmental crises – compounds existing inequities, especially in places where health systems are already weak. Distinct and overlapping threats from conflict, climate change and the cost-of-living crisis present life-or-death challenges to those already facing extreme vulnerability, particularly women and girls, and small and sick newborns. Preterm birth: a marker of maternal and neonatal health progress in the coming decade The detrimental impacts of preterm birth are felt along the life course and across generations. The success of countries and the global community in preventing preterm births and ensuring high-quality care for mothers and preterm babies serves as a critical measure of progress – or failure – in advancing global efforts to improve maternal and newborn health. Plain language summary Countries have agreed on global plans and resolutions to improve maternal and newborn health. The World Health Assembly recently emphasized the need for renewed efforts in this area. Many countries have set national goals, but implementation remains a challenge as does funding. There have been advances in evidence-based interventions for preterm birth prevention and care, reflected in updated World Health Organization guidelines. Progress has also been made in community engagement, with parent groups and healthcare organisations as leading advocates. However, overlapping crises hinder progress, including conflicts, climate change, pandemics, and the cost-of-living crisis. These crises increase inequities and pose serious risks to women and newborns, especially where health systems are weak. Preterm birth is an important indicator of progress on maternal and neonatal health. How well countries and the global community address preterm birth and provide care for mothers and babies will show their overall success or failure in improving maternal and newborn health more broadly. Key findings • Over the past decade, global and national policy frameworks, targets and plans relevant to preterm birth have been adopted, though significant funding gaps remain. •  Knowledge of ‘what works’ to prevent and delay preterm birth and to care for babies who are born preterm has improved and is reflected in updated World Health Organization technical guidelines. •  The world has flatlined on preterm birth prevention resulting in renewed urgency to learn from and fully leverage knowledge gained over the past decade to accelerate progress in the next decade. •  Overlapping and compounding challenges of climate change, conflict, pandemics and the cost-of-living crisis pose significant direct and indirect risks for pregnant women and preterm babies and must be mitigated. •  Addressing preterm birth is a key component of integrated maternal and newborn health across the continuum of care and along the life course, and a key marker of progress.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Analysis / Care and treatment / Child mortality / Children & youth / Climatic changes / Complications and side effects / Developing countries / Disability / Disease / epidemiology / Evidence / Families & family life / Female / Global Health / Gynaecology, Obstetrics and Reproductive Medicine / Gynekologi, obstetrik och reproduktionsmedicin / Health aspects / Health Policy / Humans / Infant / Infant, Newborn / Innovation / LDCs / Life expectancy / Maternal & child health / Maternal and Child Health / Maternal mortality / Medicine / Medicine & Public Health / Mothers / Neonatal / Neurodevelopmental disorders / Newborn / Patient outcomes / Policy / Pregnancy / Premature babies / Premature Birth / Premature Birth - epidemiology / Premature Birth - prevention & control / Preterm birth / Prevention / prevention & control / Public Health / Reproductive health / Reproductive Medicine / Stillbirth / Sustainable development / Women's rights / Womens health