Table 4 Actions to improve national preterm birth rate data

Consensus on definition of preterm birth for international comparison, specifying gestational age

Simplified, lower cost, consistent measures of gestational age (GA) Widespread use and recording of GA

Consistent inclusion of all live births of all gestations or weight, and noting if singleton or multiple births and noting the proportion that are under 500 g/22 weeks and under 1,000 g/28 weeks for international comparison Also record all stillbirths from 500 g/22 weeks and 1,000 g/28 weeks (whilst collecting by other national definition for stillbirth if different e.g., 20 weeks in United States)

Denominator (number of births)

Consistent measurement of all live births of all gestations noting if less than 22 weeks and if singleton or multiple births

Also record all stillbirths

Actions to improve the data

Focus on capture and consistency:

Gestational age and birthweight recording for all births

Improve reporting of neonatal cause of death with preterm as direct cause and as risk factor (counting deaths of preterm babies who die from other causes)

Collection of impairment data e.g., cerebral palsy and retinopathy of prematurity (ROP) rates according to a basic minimum dataset to increase consistency

For settings where additional capacity available:

Improve measurement e.g. gestational age assessment using early, high-quality ultrasound scan, development and refinement of improved gestational age assessment tools for use in low-resource settings

Increase the granularity of the data:

Record if provider-initiated, e.g., cesarean birth, or spontaneous and the basic phenotype, e.g. infection/relative contribution of each cause especially multiple births

Improve the linkage of data to action: e.g., collating data by gender, socioeconomic status, ethnicity, subnational e.g. state

Impairment data according to a more comprehensive standard dataset

Data for action

Set goals for national and global level for

1. Reduction of deaths amongst preterm babies by 2025

2. Reduction of preterm birth rates by 2025

Regular reporting of preterm birth rates and preterm-specific mortality rates at national level and to global level to track against goals