Preterm birth: new WHO guidance for saving lives

WHO PretermAn estimated 15 million babies are born preterm annually. Preterm birth complications account for more than 15% of deaths in children younger than 5 years and survivors often have long-term consequences with respect to their health, growth, and psychosocial functioning. [1]

On August 23, 2015 The WHO published a new evidence based guidance on interventions for pregnant women in whom preterm birth is imminent (including antenatal corticosteroids, tocolytics, magnesium sulfate, antibiotics, and mode of delivery) and for care of preterm neonates (including thermal care, continuous positive airway pressure [CPAP], surfactant administration, and oxygen therapy) to improve preterm birth outcomes. [2]

The primary audience for this evidence based clinical practice guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programs and policy-makers in all settings. The guideline will also be useful to those directly providing care to pregnant women and preterm infants, such as obstetricians, pediatricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for pre- and in-service training of health workers to enhance their delivery of maternal and neonatal care relating to preterm birth.

This guideline was jointly developed by the Department of Maternal, Newborn, Child and Adolescent Health and the Department of Reproductive Health and Research at the World Health Organization (WHO) in Geneva, who oversaw systematic searches, synthesis, and assessment of the evidence.

The Department of Maternal, Newborn, Child and Adolescent Health and the Department of Reproductive Health and Research of the WHO gratefully acknowledge the contributions that many individuals and organizations have made to the development of this guideline. Rajiv Bahl, A. Metin Gülmezoglu, Alexander Manu, Matthews Mathai, Olufemi Oladapo and Severin von Xylander were members of the WHO Steering Group that managed the guideline development process. Carl Bose, Wally Carlo, Agustin Conde-Agudelo, Caroline Crowther, Bissallah Ekele, Rogelio Gonzalez, Malik Goonewardene, Gill Gyte, William J. Keenan, Joy Lawn, Pisake Lumbiganon, Silke Mader, Elizabeth Molyneux, Rintaro Mori, Ashraf Nabhan, Regina Obeng, Vinod Paul, Zahida Qureshi, Larry Rand, Ola Didrik Saugstad, Andrew Shennan, Jeffrey Smith, João Paulo Souza, Alan Tita and Khalid Yunis served as the members of the Guideline Development Group (GDG). James Neilson and Roger Soll served as chairs of the entire group and the newborn health subgroup, respectively. Therese Dowswell, Sonja Henderson, Nancy Medley, and Helen West coordinated and reviewed the scientific evidence, prepared the GRADE tables, and drafted the narrative summaries related to maternal interventions included in this guideline. Natasha Hezelgrave reviewed these narrative summaries and double-checked the corresponding GRADE tables. For evidence related to newborn interventions, Agustin Conde-Agudelo, Joy Lawn, and Jeeva Sankar conducted systematic reviews and prepared the corresponding GRADE tables. The WHO Steering Group members drafted the final guideline document before it was reviewed by the GDG and external reviewers.

References

  1. Vogel, J.P., et al., New WHO recommendations to improve the outcomes of preterm birth. The Lancet Global Health.
  2. World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes. World Health Organization, Geneva; 2015 http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/preterm-birth-guidelines/en
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