Question 1

What is preterm birth?

Accepted Answer

Preterm birth is delivery before 37 completed weeks of gestation — the normal human pregnancy being approximately 40 weeks. The earlier the birth, the more immature the baby's organs and the greater the risk of death and disability. 15 million preterm births occur annually; they are the leading cause of under-5 child mortality globally.

Question 2

What causes preterm birth?

Accepted Answer

Preterm birth has multiple causes: infection and inflammation (chorioamnionitis — bacterial infection of the amniotic membranes is the most common cause in very preterm birth); preeclampsia and eclampsia (leading to medically indicated preterm delivery); multiple pregnancy (twins/triplets dramatically increase preterm risk); uterine anomalies; prior preterm birth (strongest predictor — 20-30% recurrence risk); cervical insufficiency; and — in most cases — unknown causes. Poverty, poor nutrition and inadequate antenatal care increase risk.

Question 3

What are the consequences of preterm birth?

Accepted Answer

Short-term: respiratory distress syndrome (most common complication); necrotising enterocolitis; intraventricular haemorrhage (brain bleeding); retinopathy of prematurity (vision damage); hypothermia; sepsis. Long-term: neurodevelopmental disability (cerebral palsy, cognitive impairment, behavioural problems — proportional to prematurity severity); chronic lung disease (bronchopulmonary dysplasia); increased NCD risk in adulthood (cardiovascular disease, diabetes).

Question 4

What treatments save preterm babies?

Accepted Answer

The most impactful interventions: antenatal corticosteroids (accelerate lung maturity — 30-40% mortality reduction); magnesium sulfate (cerebral palsy prevention — 30% reduction); kangaroo mother care (skin-to-skin — 36% mortality reduction, available at zero cost); CPAP (respiratory support — available without ventilator); surfactant therapy (for RDS); warmth and nutrition support. These interventions could prevent approximately 75% of preterm deaths if universally implemented.

Question 5

What is kangaroo mother care?

Accepted Answer

Kangaroo mother care (KMC) involves continuous skin-to-skin contact between a preterm baby and its mother (or caregiver), with the baby placed upright against the chest, covered by a blanket. A landmark 2021 WHO trial (ECOSPHERE) showed that early KMC (initiated within hours of birth, before stabilisation) reduced mortality in very low birthweight babies by 25% compared to conventional incubator care — revolutionising preterm management in LMIC settings.

Question 6

Can preterm birth be prevented?

Accepted Answer

Partially. Progesterone supplementation (vaginal or IM 17-OHPC) reduces recurrent preterm birth by 30-45% in women with prior preterm birth or short cervix. Cervical cerclage (stitch) is effective for cervical insufficiency. Treating infections promptly, smoking cessation, adequate nutrition and good antenatal care reduce risk. Multiple pregnancy (the largest rising cause in high-income countries — from IVF) is reduced by single embryo transfer policies.

Question 7

What is the treatment gap for preterm care in LMICs?

Accepted Answer

94% of preterm births occur in LMICs — yet the most effective interventions are missing: less than 10% of eligible women in LMICs receive antenatal corticosteroids; kangaroo mother care is underimplemented even where available; CPAP is absent in most district hospitals. A WHO study estimated that scaling up 10 proven newborn care interventions in 75 countries could prevent approximately 72% of all neonatal deaths.

Question 8

How does preterm birth affect brain development?

Accepted Answer

The third trimester of pregnancy is a critical period for brain development — rapid neuronal growth, white matter myelination and synaptic connectivity formation all occur from 24-40 weeks. Preterm birth interrupts this process outside the optimal uterine environment. The risk of cerebral palsy is 80 times higher in extremely preterm babies than term babies; cognitive difficulties and behavioural problems are common even in moderate-late preterm babies.

Question 9

What is the Born Too Soon Decade of Action?

Accepted Answer

Born Too Soon: Decade of Action (2023-2030) is a WHO/UNICEF/UNFPA-led global campaign targeting dramatic reductions in preterm mortality and disability — focusing on universal access to KMC, antenatal corticosteroids, CPAP and nutrition support; elimination of medically unjustified early induction; and newborn data improvement. It coordinates with the Every Newborn Action Plan and SDG 3.2 targets.

Question 10

Is preterm birth related to long-term adult health?

Accepted Answer

Yes — the Developmental Origins of Health and Disease (DOHaD) framework shows that preterm birth is associated with significantly elevated adult risks of cardiovascular disease (preterm babies have higher blood pressure, altered cardiac structure), type 2 diabetes, metabolic syndrome, asthma, mental health disorders and reduced cognitive function. These associations reflect incomplete development during critical windows.

Question 11

How does GMJ News cover preterm birth?

Accepted Answer

GMJ News covers WHO preterm birth data, Born Too Soon campaign, KMC evidence, antenatal corticosteroid access, preterm brain development research and Georgia's neonatal health indicators. Preterm birth prevention and care are direct PHIG public health priorities.

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