Preterm birth is now the leading cause of death globally for children under age 5

For the first time in history, the complications of preterm birth outrank all other causes as the world’s number one killer of young children. This was the main finding of a paper we published in the Lancet in 2014 (

Direct complications from preterm births accounted for 965,000 deaths during the first 28 days of life, with an additional 125,000 deaths between the ages of one month and five years. Other main causes for young child deaths include pneumonia, which killed 935,000 children under-five, and intrapartum-related complications or childbirth complications, which caused 720,000 deaths. The main reason that preterm birth has become the leading cause of child death is the successes that have been achieved in reducing the leading causes of death beyond the neonatal period.

Since 2000, the worldwide rate of under-five child deaths has declined dramatically from 76 to 46 deaths per 1,000 live births in 2013. This is an annual reduction of 3.9 percent. Almost half of the overall reduction is a result of the progress made against deaths from pneumonia, diarrhea, measles, HIV and tetanus. In contrast, preterm deaths have reduced at only 2.1 percent annually. This reflects major investments in vaccines, bed nets for malaria, antibiotics, antimalarial and HIV.

We have just published a paper in the WHO Bulletin which presents more detailed results of the latest cause of death estimates for the neonatal period.

This paper estimates the cause-of-death distributions in the early (0–6 days of age) and late (7–27 days of age) neonatal periods, for 194 countries between 2000 and 2013. Of the 2.8 million neonatal deaths in 2013, 0.99 million deaths were estimated to be caused by preterm birth complications, 0.64 million by intrapartum complications and 0.43 million by sepsis and other severe infections. Preterm birth (40.8%) and intrapartum complications (27.0%) accounted for most early neonatal deaths while infections caused nearly half of late neonatal deaths. Preterm birth complications were the leading cause of death in all regions of the world.

Most newborn deaths are preventable and opportunities for addressing newborn health are unprecedented especially when effectively integrated with care for women and children. Today, much more is known about effective interventions and service delivery channels, and of approaches to accelerate coverage and quality of care. WHO has consulted with multiple stakeholders to develop a global action plan called Every Newborn: an action plan to end preventable deaths (ENAP).

This plan was endorsed by the 2014 World Health Assembly. Specific goals and targets for the post-2015 period are being developed now for neonatal and maternal health, and will be linked to the action plan.

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