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Am J Perinatol 2016; 33(03): 276-289
DOI: 10.1055/s-0035-1571199
Prematurity Special Issue
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Worldwide Epidemic: The Problem and Challenges of Preterm Birth in Low- and Middle-Income Countries

Marcela C. Smid
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
,
Elizabeth M. Stringer
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
,
Jeffrey S. A. Stringer
2   Division of Global Women's Health, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
› Author Affiliations
Further Information

Publication History

18 November 2015

24 November 2015

Publication Date:
03 February 2016 (online)

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Abstract

Preterm birth (PTB) is the most common cause of neonatal death worldwide and the second leading cause of under-5 mortality. Low- and middle-income countries (LMICs) bear a disproportionate burden of this disease. An estimated 1 million preterm infants die in the neonatal period each year and many of those who survive face lifelong disability. In this review, we explore the global burden of PTB through an examination of risk factors and predisposing clinical conditions found in LMICs. We then discuss current interventions available to prevent PTB and/or mitigate its clinical sequelae. A major finding of this review is that although the majority of the global PTB disease burden is shouldered by LMICs, very little of the research evidence for its prevention and treatment derives from these settings. Primary research and implementation studies that involve LMIC populations are urgently needed.

Keywords

global health - preterm birth - prematurity - low- and middle-income countries
 

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