This comprehensive narrative review examines the progress and challenges in addressing preterm birth over the past decade to inform future action. The article reveals both encouraging advances and concerning stagnation in the global response to preterm birth.
The research highlights significant policy progress at the global level, with countries supporting initiatives like the Every Newborn Action Plan and World Health Assembly resolutions calling for renewed commitment to maternal and newborn health. Most countries have established national mortality targets, though only 61% have costed their plans and just 12% report full financing. The past decade has seen substantial advances in evidence-based interventions for preterm birth prevention and care, reflected in updated WHO guidelines on antenatal, intrapartum and postpartum care, and care for small and sick newborns.
However, the authors emphasize that rates of preterm birth have remained largely unchanged between 2010 and 2020, with an estimated 1 in 10 babies still born preterm worldwide. The article introduces the concept of “polycrisis” – overlapping economic, geopolitical, and environmental crises including conflict, climate change, pandemics, and cost-of-living pressures that compound existing inequities and pose serious risks to women and newborns, especially in fragile settings.
The review identifies important conceptual shifts for the coming decade, including expanding focus beyond preterm babies to include all vulnerable newborns and stillbirths, emphasizing sexual and reproductive health rights of adolescent girls, and adopting people-centered and rights-based approaches to care. The authors argue that success in preventing preterm births and ensuring high-quality care serves as a critical marker of progress in advancing global maternal and newborn health efforts overall.
