A recent four-paper series published in The Lancet highlights the significance of implementing eight low-cost and easily implementable interventions for pregnant women in 81 low- and middle-income countries (LMICs). These interventions have the potential to prevent approximately 566,000 stillbirths and 5.2 million babies from being born preterm or small for gestational age, including those with low birth weight. The long-term health and economic benefits resulting from these interventions cannot be overlooked.
The eight interventions identified in the series include multiple micronutrient supplements, balanced protein energy supplements, aspirin, treatment of syphilis, education for smoking cessation, prevention of malaria in pregnancy, treatment of asymptomatic bacteriuria, and progesterone provided vaginally. Additionally, two interventions that can reduce complications of preterm births—antenatal corticosteroids and delayed cord clamping—were also highlighted.
The estimated cost of implementing these interventions in 2030 is $1.1 billion. By adopting these measures, it is projected that 476,000 newborn baby deaths could be prevented. The Lancet Series emphasizes that despite the availability of these interventions, progress in reducing preterm birth and low birthweight remains stagnant in every region, falling off track of the Global Nutrition Target.
In 2020, out of the 135 million babies born alive, one in four (35.3 million) were born preterm or small for gestational age. These small vulnerable newborns (SVNs) were born in all countries, with a majority in Sub-Saharan Africa and Southern Asia. The authors call for a global call to action, urging for higher quality care for women during pregnancy and childbirth. They specifically advocate for the scale-up of pregnancy interventions in LMICs, which could prevent approximately 32% of stillbirths, 20% of newborn baby deaths, and 18% of all SVN births in these countries.
Given that over 80% of births occur in facilities, the authors emphasize the importance of better data collection and utilization. Accurate gestational age dating for every pregnancy and weighing and classification of all newborns and stillbirths by SVN type are crucial. Improved data collection not only contributes to providing good quality care but also informs progress and drives accountability.
The Lancet Series emphasizes the need to address the global burden of SVN outcomes. Despite various commitments and targets to reduce these outcomes since 1990, one in four babies worldwide is still born too small or too soon. The knowledge to reverse this trend already exists, and with an investment of $1.1 billion, hundreds of thousands of babies' lives can be saved. Urgent action, advocacy, and investment from national actors and global partners are crucial to bring about the necessary change.