Preventing preterm birth and neonatal mortality: exploring the epidemiology, causes, and interventions

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Global Health

Background:

• Preterm birth (before 37 weeks gestation) is a major global health challenge.
• It is the leading cause of neonatal mortality, contributing to over one million deaths annually.
• Low- and middle-income countries bear a disproportionate burden of preterm birth complications.

Purpose of the Study:

• To review the global burden and causes of preterm birth.
• To evaluate the evidence for existing interventions for preterm birth prevention and neonatal survival.
• To highlight the need for further research and implementation of effective strategies.

Main Methods:

• Literature review and synthesis of existing research on preterm birth.
• Analysis of intervention effectiveness based on evidence quality.
• Assessment of global disparities in preterm birth outcomes.

Main Results:

• Few interventions show moderate-to-high quality evidence for decreasing preterm birth (e.g., progesterone, cervical cerclage).
• Interventions to improve neonatal survival (e.g., maternal steroids, kangaroo mother care) are effective but underutilized.
• Causes of preterm birth are multifactorial and context-specific.

Conclusions:

• Urgent research is needed to understand context-specific causes of preterm birth.
• Development and implementation of efficacious prevention and survival strategies are critical.
• Scaling up proven interventions is essential to reduce neonatal mortality and morbidity.