Eric O. Ohuma|Ann?Beth Moller|Ellen Bradley|Samuel Chakwera|Laith Hussain-Alkhateeb|Arie Y. Lewin|Yemisrach B. Okwaraji|Wahyu Retno Mahanani|Emily White Johansson|Tina Lavin|Dorothy Z. Fernandez|Giovanna Gatica Domínguez|Ayesha De Costa|Jenny A. Cresswell|Julia Krasevec|Joy E Lawn|Hannah Blencowe|Jennifer Requejo|Allisyn C Moran
National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis
London School of Hygiene & Tropical Medicine|World Health Organization|London School of Hygiene & Tropical Medicine|United Nations Children's Fund|University of Gothenburg|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|World Health Organization|Uppsala University|World Health Organization|World Health Organization|World Health Organization|World Health Organization|World Health Organization|United Nations Children's Fund|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|United Nations Children's Fund|World Health Organization
backgroundpreterm birth leading cause neonatal mortality associated longterm physical neurodevelopmental socioeconomic effects study updated national preterm birth rates trends plus novel estimates gestational age subgroups inform progress towards global health goals targets aimed update country regional global estimates preterm birth 2020 addition trends 2010 2020methodswe systematically searched populationbased nationally representative data preterm birth jan 1 2010 dec 31 2020 study data 26 march14 april 2021 countries areas nationallevel data analysis included 679 data points 86 nationally representative administrative data 582 679 data points 103 countries areas 62 countries areas nationally representative administrative data 64 103 data points bayesian hierarchical regression used estimating countrylevel preterm rates incoporated countryspecific intercepts low birthweight covariate nonlinear time trends bias adjustments based data quality categorisation indicators method gestational age estimationfindingsan estimated 134 million 95 credible interval cri 123152 million newborn babies born preterm 37 weeks 2020 99 births 95 cri 91112 compared 138 million 127155 million 2010 98 births 90110 worldwide global annual rate reduction estimated 014 2010 2020 total 556 total livebirths southern asia 268 36 099 000 134 767 000 subsaharan africa 287 38 819 300 134 767 000 yet two regions accounted approximately 65 8 692 000 13 376 200 preterm births globally 2020 33 countries areas highest data quality category none southern asia subsaharan africa compared 94 30 32 countries highincome countries areas worldwide 2010 2020 approximately 15 preterm births occurred less 32 weeks gestation requiring neonatal care 28 weeks 42 95 ci 3150 567 800 410 200663 200 newborn babies 2832 weeks 104 95106 1 392 500 1 274 8001 422 600 newborn babiesinterpretationthere measurable change preterm birth rates last decade global level despite increasing facility birth rates substantial focus routine health data systems remain many missed opportunities improve preterm birth data gaps national routine data preterm birth marked regions southern asia subsaharan africa also highest estimated burden preterm births countries need prioritise programmatic investments prevent preterm birth ensure evidencebased quality care preterm birth occurs investments improving data quality crucial preterm birth data improved used action accountability processesfundingthe childrens investment fund foundation undp united nations population fundunicefwhoworld bank special programme research development research training human reproduction