Preterm birth
Birth before 37 completed weeks of pregnancy. The term covers two things: the baby who is born early, and the pregnancy that is likely to end early. WHO writes its advice on steroid injections before an early birth for women who are likely to give birth early, and its advice on the care of the baby for babies born early.
- Condition
- In this atlas
Overview
Technical summary
WHO 2022 (antenatal corticosteroid guideline) defines preterm birth as "a baby born prior to 37 completed weeks of gestation". WHO 2022 (care of the preterm or low-birthweight infant) writes the preterm infant as under 37 weeks of gestation. The cut-off is WHO’s. Claims on this record state their recipient and keep the sides apart. For treatment given to the woman before the birth, the WHO recommendation is about women with a high likelihood of preterm birth (maternal recipient), while the ACTION-I result counts the newborn’s deaths (newborn recipient). Claims about the care of the baby after the birth concern the baby born early (WHO immediate kangaroo mother care). Other definitions, subdivisions by gestational age and causes are not recorded here.
Burden
No burden claims are published.
Claims and evidence
No claims are published for this condition yet.
Clinical links
Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.
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Claim, not a settled fact Recommended for this: Antenatal corticosteroids
Applies to Maternal- Women with a high likelihood of preterm birth within 7 days of starting therapy, from 24 weeks to 34 weeks 0 days of gestation. The woman receives the treatment and the preterm newborn is the intended beneficiary. The recommendation sets the lower limit at 24 weeks, and the Remarks set 34 weeks 0 days as the upper limit.
- Health-care facilities that can meet the five conditions, including accurate gestational age assessment, adequate childbirth care and adequate care of the preterm newborn. The Remarks say harm cannot be excluded where the conditions cannot be met, such as lower-level health facilities and the community level. They also say antenatal corticosteroids should not be routinely administered where ultrasound for gestational age assessment cannot be performed.
- Global (WHO guideline; no country is excluded, but the conditions must be met)
- Pregnancy
- Gestational age 24 weeks 0 days to 34 weeks 0 days
- Postnatal age Not reported
WHO recommends antenatal corticosteroid therapy for women with a high likelihood of preterm birth from 24 weeks to 34 weeks of gestation, but only when five conditions are met: gestational age can be assessed accurately, preterm birth is highly likely within 7 days of starting treatment, there is no clinical evidence of maternal infection, adequate childbirth care is available (including capacity to recognize and safely manage preterm labour and birth), and the preterm newborn can receive adequate care, including resuscitation, kangaroo mother care, thermal care, feeding support, infection treatment and respiratory support including continuous positive airway pressure (CPAP) as needed. WHO introduces that list with the word including, so the items are examples of adequate newborn care and the list is not complete. WHO's Remarks add that antenatal corticosteroids should not be routinely given where ultrasound for gestational age assessment cannot be performed. WHO classes this as a context-specific recommendation, from its 2022 update that replaced its 2015 advice. The woman is treated and the newborn is the intended beneficiary.Limitations. WHO's four recommendation categories are not GRADE strong or conditional labels. WHO rates certainty for each outcome with GRADE and gives no single certainty rating for a recommendation, so certainty is not assessed here. The Remarks say harm cannot be excluded where the conditions cannot be met, such as lower-level health facilities and the community level. The guideline group chose 34 weeks 0 days as the upper limit because of uncertainty in the balance of benefit and harm at later gestational ages. WHO says the recommendations may be updated when new evidence appears. On 2026-10-11 title searches of WHO IRIS found no later WHO antenatal corticosteroid guideline; that is a search result, not proof of absence.
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Claim, not a settled fact Evaluated for this: Antenatal corticosteroids
Applies to Newborn- Liveborn infants of the randomized women. The window of 26 weeks 0 days to 33 weeks 6 days is the mother's gestational age when she entered the trial. It does not limit the infant's gestational age at birth, and the research gives no such limit. Birth occurred before 37 weeks for 90.0% of infants in the dexamethasone group and 90.8% of infants in the placebo group.
- Hospital-based: 29 secondary- and tertiary-level hospitals across six study sites. The hospitals were chosen after a standard assessment so that the WHO conditions for antenatal corticosteroid use could reasonably be met.
- Bangladesh, India, Kenya, Nigeria and Pakistan
- Neonatal period, birth to 28 days
- Gestational age Not reported
- Postnatal age 0 days to 0 days
In the ACTION-I trial, pregnant women at risk of imminent preterm birth, from 26 weeks 0 days to 33 weeks 6 days of pregnancy, received either dexamethasone or a dummy injection. Fewer of their liveborn babies died in the first 28 days of life in the dexamethasone group: 278 of 1417 (19.6%) against 331 of 1406 (23.5%) in the placebo group (relative risk 0.84, 95% CI 0.72 to 0.97). The medicine was given to the mother, and the outcome counted here is the baby's.Limitations. One placebo-controlled trial in 29 secondary- and tertiary-level hospitals in five low-resource countries. The hospitals were chosen so that the WHO conditions for steroid use could reasonably be met, so the result does not describe lower-level facilities or the community. The trial stopped early for benefit, short of its planned sample. About 90% of the infants were born before 37 weeks. The authors report that 45% of women received fewer than four doses, and name the difficulty of standardizing care across sites and the use of third-trimester ultrasound to confirm gestational age for many participants as limits. The relative risk is model-based, adjusted for site and for multiple births, with intervals adjusted for multiplicity. Figures come from the PubMed abstract and the Author Final Manuscript; the version of record was not fetched (HTTP 403) and the figures were not checked against it.
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Claim, not a settled fact Recommended for this: Immediate kangaroo mother care
Applies to Newborn- Preterm or low-birth-weight infants. This is broader than the iKMC trial's 1.0 to under 1.8 kg band.
- Health-care facility or home. The A.1b remarks give separate conditions for each.
- Global (WHO guideline; the setting text says "any country or setting")
- Newborn, from birth
- Gestational age Not reported
- Postnatal age at least 0 days
WHO recommends starting kangaroo mother care as soon as possible after birth for babies who are born early or small (preterm or low-birth-weight infants). WHO rates this a strong recommendation based on high-certainty evidence.Limitations. The population, all preterm or low-birth-weight infants, is broader than any single trial. In facilities, the remarks exclude infants who cannot breathe spontaneously after resuscitation, are in shock or need mechanical ventilation. The PDF prints the strength parenthetical twice in succession. The GRADE evidence tables are in a web supplement that was not fetched.
Record details
- Record id
maternal:preterm-birth- Content hash
15352135ac453fe1ab6f09a18b94848fb9bf3d21c4cac636d9ae7c1ce442d333