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Global, regional, and national estimates of levels of preterm birth in 2014: A systematic review and modelling analysis

The Lancet Global Health Dec 19, 2018

Chawanpaiboon S, et al. - Researchers conducted a systematic review and modelling analysis to estimate global, regional, and national rates of preterm birth in 2014, with trends over time for some selected countries. Findings revealed that preterm birth remains a crucial issue in the mortality of children and improving the quality of maternal and newborn care. In order to better understand the preterm birth epidemiology, the quality and volume of data must be improved, including the standardization of definitions, measurements and reports.

Methods
  • Data on preterm birth for 194 WHO Member States were systematically searched from 1990 to 2014 in databases of national civil registration and vital statistics (CRVS).
  • Researchers have also investigated population-representative surveys and research studies for countries with no or limited CRVS data.
  • Data are reported directly for 38 countries with high-quality data for preterm births in 2014.
  • They used a linear mixed regression model to estimate preterm birth rates for countries with at least three data points between 1990 and 2014.
  • For 2014, they also calculated regional and global estimates of preterm birth.

Results
  • One thousand, two hundred forty-one data points across 107 countries were identified.
  • The global preterm birth rate for 2014 was estimated at 10·6% (uncertainty interval 9·0–12·0), equivalent to an estimated 14·84 million (12·65 million–16·73 million) live preterm births in 2014.
  • In Asia and sub-Saharan Africa, 12· 0 million (81·1%) of these preterm births occurred.
  • For 2014, the regional preterm birth rate in North Africa ranged from 13·4% (6·3–30·9) to 8·7% (6·3–13·3) in Europe.
  • In 2014, India, China, Nigeria, Bangladesh, and Indonesia accounted for 57·9 million (41×4%) of 139·9 million livebirths and 6·6 million (44×6%) of preterm births worldwide.
  • Of the 38 high-quality data countries, preterm birth rates have increased in 26 countries since 2000 and decreased in 12 countries.
  • Globally, the estimated preterm birth rate was 9×8% (8×3–10×9) in 2000, and 10×6% (9×0–12×0) in 2014.
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