The first-ever country-by-country estimate of premature births finds that 15 million babies a year are born preterm -- more than one in 10 live births.
About 1 million of those babies die shortly after birth, and countless others suffer a significant, life-long physical, neurological or educational disability, says a report released Wednesday.
The findings "dispel the notion that this is a rare problem," said a co-editor of the report, Joy Lawn of Save the Children.
Although more than 60% of preterm births are in sub-Saharan Africa and South Asia, early births are also a problem for some high-income countries, including the USA and Brazil. In the USA, about 12% of all births are preterm, a percentage far higher than in other developed countries.
Factors driving up the U.S. rate include the number of older women having babies; increased use of fertility drugs, which increase the risk of multiple births; and increased rates of medically unnecessary cesarean deliveries and inductions "done at the convenience of the doctor or mother," said a co-editor, Christopher Howson of the March of Dimes. Others involved were the World Health Organization and the Partnership for Maternal, Newborn and Child Health.
In addition to a notable age gap (the rate for women ages 20-35 was 11% to 12% vs. 15% for those under 17 and over 40), a considerable racial gap also exists in the USA, Howson said. The preterm birth rate for blacks in 2009 was as high as 17.5%, vs. 10.9% for whites.
In the USA, "preemies have among the highest survival rates in the world," Howson said. "Where we fall flat is on the prevention side. We need to do a lot more such as improving health care access for all, bringing down rates of smoking and unnecessary C-sections and inductions."
Globally, preterm births are the second leading killer of children under 5. "Numbers haven't come down very much, especially when you compare it to things like pneumonia, diarrhea -- where we've really made progress -- malaria and HIV, where we've also made significant progress," Lawn said.
For the report, preterm was defined as 37 weeks of completed gestation or less. Full term is 39 weeks.
An estimated 75% of the world's 1 million preterm deaths could be avoided if a few "proven and inexpensive treatments and preventions" were widely available, the report says. These include teaching "kangaroo care," in which tiny babies are held skin-to-skin on their mother's bare chests for warmth when there are no incubators.
Also, steroid injections for mothers in premature labor, which cost $1 an injection, help develop immature fetal lungs and prevent respiratory problems.
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