Providing simple and cheap healthcare measures to pregnant women – such as offering aspirin – could prevent more than a million babies from being stillborn or dying as newborns in developing countries every year, new research said on Tuesday.
An international team of researchers also estimated that one quarter of the world's babies are born either premature or underweight, adding that almost no progress is being made in this area.
The researchers called for governments and organizations to ramp up the care women and babies receive during pregnancy and birth in 81 low- and middle-income countries.
Eight proven and easily implementable measures could prevent more than 565,000 stillbirths in these countries, according to a series of papers published in The Lancet journal.
The measures included providing micronutrient, protein, and energy supplements, low-dose aspirin, the hormone progesterone, education on the harms of smoking, and treatments for malaria, syphilis, and bacteria in urine.
If steroids were made available to pregnant women and doctors did not immediately clamp the umbilical cord, the deaths of more than 475,000 newborn babies could also be prevented, the research found.
Implementing these changes would cost an estimated US$1.1 billion, the researchers said.
This is "a fraction of what other health programs receive", said Per Ashorn, a lead study author and professor at Finland's Tampere University.
Another study author, Joy Lawn of the London School for Hygiene and Tropical Medicine, told AFP that the researchers used a new definition for babies born premature or underweight.
She said the traditional way to determine a baby had a low birthweight – if it was born weighing under 2.5 kilograms (5.8 pounds) – was "a bit randomly selected" by a Finnish doctor in 1919.
This "very blunt measure" has remained the benchmark for more than a century, despite plentiful evidence that "those babies are not all the same", Lawn said.
The researchers analyzed a database that included 160 million live births from 2000 to 2020 to work out how often babies are born "too soon and too small", she said.
"Quite shockingly, we found that this is much more common once you start to think about it in a more nuanced way."
The researchers estimated that 35.3 million – or 1 in 4 – of the babies born worldwide in 2020 were either premature or too small, classifying them under the new term "small vulnerable newborns".
While most of the babies were born in southern Asia and sub-Saharan Africa, Lawn emphasized that every country was affected.
One reason progress has flatlined is that these problems tend "to be something that happens to families and women with less of a voice", Lawn said.
For example, pregnant African American women in the United States received a lower level of care than other groups, she added.