Leading article: The riddle of early births

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All across the developed world the number of babies being born prematurely seems to be rising. A study of American mothers by the Institute of Medicine in New York has revealed that their number has increased by 30 per cent in the past quarter of a century. A Danish study carried out last year and published in the British Medical Journal showed a similar trend: a 22 per cent increase in premature births between 1995 and 2004. The same phenomenon is almost certainly taking place in Britain, where 45,000 babies are now born prematurely (before 37 weeks) each year.

The medical establishment can point to no definitive explanation for this astonishing rise. A number of factors have been posited. Rising levels of obesity is one theory. This often results in diabetes, which makes pregnant mothers more prone to give birth prematurely. The rising age profile of mothers is likely to be contributing too. Older mothers tend to give birth earlier. The boom in IVF treatment is another factor. The planting of a large number of embryos in the womb makes multiple births, and hence premature delivery, more probable. Another theory is that what we are seeing is the consequence of our great success in saving the lives of babies born prematurely. Twenty-five years ago relatively few survived compared with today. It has been suggested that those born prematurely are more likely to have premature children of their own.

What we can be reasonably sure of is that the trend will continue. This has pressing implications for our societies. We need more provision for such children. Premature babies require intensive medical and nursing care in their early months to ensure their under-developed organs and body systems do not suffer damage. Already there are signs of strain on the National Health Service. Staff shortages mean that many ill babies are being transported hundreds of miles across the country for treatment. Ninety per cent of intensive care units have been forced to turn away admissions at some point because of a lack of nursing staff. And only 3 per cent are operating with the recommended ratio of one nurse per baby.

These children and their parents also need more help after they leave hospital. Around half such children suffer from some form of disability. This latest US study estimates that some $26bn is spent on the early medical care and education of premature babies. Our governments must make provision for more of this sort of assistance. And just as pressing is the need for more research into exactly what lies behind this runaway rise in premature births. We need to address the cause, rather than simply reacting to the consequences, of these thousands of babies being born too soon.

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