Preconception Health

One of the targets under the global goal for health (SDG 3) is to "end preventable deaths of newborns and children under 5 years of age" by 2030. However, it is said that this target can only be achieved by reducing preterm births and birth defects.

Globally, birth defects and preterm births affect 23 million babies every year. These two conditions also account for over 25% of all under-five deaths globally. Furthermore, the burden of morbidity, disability and mortality from birth defects and preterm births are particularly high in low- and middle- income countries (LMICs) where many women suffer from poor general health and nutritional status, greater exposure to infections and environmental hazards, and limited access to health services including family planning. Public health programs, although targeting various life stages, also do not guarantee that women enter pregnancy in good health. All of these conditions in LMICs contribute to an increased risk for preterm birth and birth defects. Thus, to improve health conditions and improve birth outcomes, a significant population-based effort will be required in addition to the effort to save the lives of babies born premature or born with a birth defect through accessible medical care and support.

Preterm Births

• Preterm or premature birth refers to birth before 37 weeks of pregnancy are completed.

• Preterm birth occurs for a variety of reasons. Most preterm births happen spontaneously, but some are due to early induction of labor or caesarean birth, whether for medical or non-medical reasons.

• Common causes of preterm birth include multiple pregnancies, infections and chronic conditions such as diabetes and high blood pressure; however, often no cause is identified.

• Inequalities in survival rates around the world are stark. In low-income settings, half of the babies born at or below 32 weeks (2 months early) die due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties.

• Many survivors of preterm birth face a lifetime of disability, including learning disabilities and visual and hearing problems.

Birth Defects

• Congenital anomalies can be defined as structural or functional anomalies that occur during intrauterine life. Also called birth defects, congenital disorders, or congenital malformations, these conditions develop prenatally (before birth) and may be identified before or at birth, or later in life.

• The true number of cases of birth defects globally may be much higher than estimated because statistics do not often consider terminated pregnancies and stillbirths (allowed in other countries).

• The vast majority (94%) of congenital anomalies occur in low- and middle-income countries (LMICs).

• Some congenital anomalies can be prevented through screening, vaccination, fortification of staple foods with nutrients such as folic acid and iodine, and adequate antenatal care, among other methods.

• Some congenital anomalies can be treated with surgical and non-surgical options.

• Many congenital anomalies result in social stigma and discrimination, which can lead to embarrassment, isolation and other reductions in community interaction.

• Birth defects also have a high economic cost; long-term disability creates significant impact on individuals, families, health care systems and societies.

• Effects of birth defects are amplified in low- and middle-income countries where lack of accessibility and availability of support services may make living with an impairment more difficult.