Eight low-cost interventions for pregnant women in 81 low- and middle-income countries (LMICs) could prevent about 566,000 stillbirths and 5.2 million babies from being born preterm or small for gestational age every year.
The proven interventions – multiple micronutrient supplements; balanced protein energy supplements; aspirin, treatment of syphilis; education for smoking cessation; prevention of malaria in pregnancy; treatment of asymptomatic bacteriuria; and progesterone provided vaginally – could also potentially to prevent 476,000 new-born deaths, as well as affect long-term health and economic output.
A new four-paper series, published in The Lancet today, add there were a further two interventions – antenatal corticosteroids and delayed cord clamping – that can reduce the complications of preterm births.
The papers estimate the cost of implementing these interventions would be $1.1 billion in 2030.
The analysis on small vulnerable new-borns estimates that, of the 135 million babies born alive in 2020, one in four (35.3 million) were born preterm or small for gestational age.
The series brings the group together under the new term of small vulnerable newborns (SVN), and they were born in every country, but most in Sub-Saharan Africa and Southern Asia.
Progress for reducing preterm birth and low birthweight remains off track of Global Nutrition Target targets, which calls for 30% reduction of babies with low birthweight by 2030 from a 2012 baseline. The estimated annual rate of reduction stands at 0.59%.
The authors call for a higher quality of care for women during pregnancy and at birth, adding that a scale-up of pregnancy interventions in 81 LMICs could prevent approximately 32% of stillbirths, 20% of newborn baby deaths and 18% of all SVN births.
Lead author Professor Per Ashorn, of Tampere University, Finland, said: “Despite several global commitments and targets aimed at reducing SVN outcomes since 1990, every fourth baby in the world is ‘born too small’ or ‘born too soon’.
“Our Series suggests that we already have the knowledge to reverse the current trend and save the lives of 100,000s of babies a year at a cost of $1.1 billion, a fraction of what other health programmes receive. We need national actors, with global partners, to urgently prioritise action, advocate and invest.”
Ashorn P, Ashorn U, Muthiani Y, Aboubaker S et al. Small vulnerable newborns—big potential for impact.
Lawn JE, Ohuma EO, Bradley E et al. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting.
Hunter PJ, Awoyemi T, Ayede AI et al. Biological and pathological mechanisms leading to the birth of a small vulnerable newborn.
Hofmeyr GJ, Black RE, Rogozińska E et al. Evidence-based antenatal interventions to reduce the incidence of small vulnerable newborns and their associated poor outcomes.
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