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A report of major impact

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Professor John Newnham

Womens and Infants Research Foundation

King Edward Memorial Hospital

Definition and Incidence

  • Preterm birth is defined as birth before 37 and after 20 completed weeks of gestation.
  • In Australia, the rate of preterm birth is 8-9%, resulting in more than 26,000 preterm infants each year.
  • In Aboriginal populations, the rate is approximately double.

Consequences

  • Preterm birth is the single greatest cause of death and disability in children up to five  years of age in the developed world. In Western Australia, preterm birth is next to  birth defects as the major known cause of perinatal loss.
  • The consequences of preterm birth are inversely proportional to the age at birth.

Individuals born too early are at increased risk:
 

  • In the newborn period –  of death, respiratory disease, cerebral haemorrhage,  necrosis  of  the  bowel,  infections  and  prolonged  stay  in  an  intensive  care  environment.
  • In childhood – of cerebral palsy, chronic lung disease, deafness, blindness, learning difficulties and behavioural problems.
  • In adulthood – of metabolic syndrome, diabetes and heart disease.

Prevention

  • Until recently, preterm birth was thought by many to be an unavoidable consequence of human reproduction. Times have changed and preterm birth is now considered to be preventable, at least in a proportion of cases.
  • There are many pathways to untimely early birth and recent advances mean that several of these pathways can be prevented at their onset. Research discoveries now enable clinical strategies to be developed that will safely prevent a variety of the causes.