Addressing preterm births globally


Researchers and global health organisations have issued a call-to-action to advance a comprehensive research agenda to address the global burden of preterm birth, which has become the leading cause of newborn death worldwide.

Preterm birth is the leading cause of death in the first month of life, and babies who survive an early birth often face the risk of a lifetime of health challenges. Each year, an estimated 6.6 million children die worldwide by the age of five. Of those, 44 percent die within the first month of life.

The Bill & Melinda Gates Foundation, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s, and the March of Dimes Foundation convened scientific experts from around the world to develop a ‘Solution Pathway’ for preterm birth. This strategic research plan spans the spectrum of discovery, development, and delivery research needed to both accelerate prevention and reduce preterm birth death and disability. Developed by more than 30 scientific experts in the field of preterm birth and maternal-child health, the agenda was published as a commentary in The Lancet Global Health.


The agenda calls for:

  • Innovative research in the biology of pregnancy and preterm birth, and bringing new technologies and methodologies to the field of preterm research and prevention
  • Accelerating research for use of practical and affordable interventions known to improve survival of preterm infants in low- and middle-income countries
  • Improving availability of data to better understand the global burden of preterm birth, identify populations at risk, and evaluate impact of programmes aimed at reducing preterm birth, and death and disability
  • Fostering innovation and collaboration to translate research into practice.


Specific areas recommended for further research include:

  • Understanding the complex biology of pregnancy, how the body maintains a healthy pregnancy, and the complex interplay of the immune system, inflammation, hormonal control and factors of the social and physical environment that can cause infants to be born preterm
  • Investigating the female microbiome and how it relates to maintaining health as well as infection, inflammation, the immune response and preterm birth
  • The influences and interactions of genes and social and environmental factors
    “Multiple global initiatives have gained critical momentum to address neonatal mortality and… recent scientific advancements create a new opportunity for transformative research into the complex biology of pregnancy,” the authors say.
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