THE birth of a child is often a moment of joy and hope for families and communities. Yet for many parents, that joy is overshadowed by anxiety when a baby arrives too soon.

Premature birth—also known as preterm birth—remains one of the most serious challenges in maternal and newborn health, contributing significantly to infant illness and death worldwide.

A baby is considered premature when born before 37 completed weeks of pregnancy. A full-term pregnancy typically lasts about 40 weeks. When a baby is born too early, vital organs such as the lungs, brain, and digestive system may not be fully developed. The earlier the birth occurs, the greater the risk of serious health complications.

Understanding the risks of premature birth

During pregnancy, the womb provides a protective and nourishing environment where a baby grows and matures. Critical development of organs—especially the lungs and brain—takes place in the final weeks of gestation. When this process is interrupted, the baby may struggle to adapt to life outside the womb.

Premature babies often face breathing difficulties because their lungs are not fully mature. Some lack sufficient surfactant, a substance that helps keep the lungs inflated. As a result, they may require oxygen support or specialized care in neonatal intensive care units (NICUs).

The brain of a premature infant is also particularly vulnerable. Blood vessels in the brain may be fragile and underdeveloped, increasing the risk of bleeding shortly after birth. Such complications can lead to long-term neurological challenges, including learning disabilities or developmental delays.

The digestive system may not be ready to process milk effectively, leading to feeding difficulties, abdominal bloating, or infections. Because their immune systems are immature, preterm babies are also more susceptible to bacterial infections, which can quickly become life-threatening if not promptly treated.

Temperature regulation presents another challenge. Premature babies often have low body fat and struggle to maintain their body temperature, making them vulnerable to hypothermia. For this reason, many require incubators or skin-to-skin care, commonly known as kangaroo mother care.

The scale of the problem

Premature birth is a global public health concern. According to the World Health Organization, approximately 15 million babies are born prematurely each year worldwide. More than one million of them die due to complications related to preterm birth, making it one of the leading causes of death among children under five years old.

In Tanzania, the situation is equally concerning. Government statistics indicate that about one in every ten babies—over 250,000 children annually—are born prematurely. Health experts estimate that a significant proportion of neonatal admissions in major hospitals involve preterm infants, placing considerable strain on the national health system.

At Muhimbili National Hospital, the country’s largest referral facility, neonatal specialists report that preterm births account for a large share of admissions in newborn units. Many of these infants require weeks or even months of specialized care before they are stable enough to go home.

Although survival rates have improved due to advances in neonatal medicine, a substantial percentage of preterm babies continue to experience long-term complications. These may include chronic lung disease, vision and hearing impairments, anemia, cerebral palsy, and learning difficulties. Some children recover fully, while others live with lifelong challenges.

What causes premature birth?

The causes of premature birth are complex and, in some cases, not fully understood. However, medical research has identified several risk factors linked to early delivery.

Maternal health conditions whereas certain health problems in pregnant women increase the risk of preterm labour. These include high blood pressure (including preeclampsia), diabetes, chronic infections such as urinary tract infections (UTIs), asthma and severe anemia

In some situations, doctors may recommend early delivery to protect the life of the mother or baby when complications become dangerous.

Bacterial infections affecting the reproductive system can lead to inflammation and early rupture of membranes (when the “water breaks” too soon). This often triggers premature labour. Untreated infections during pregnancy significantly raise the likelihood of early birth.

Harmful behaviours during pregnancy, such as smoking cigarettes or consuming alcohol, are strongly associated with premature birth. These substances interfere with fetal development and can restrict oxygen and nutrient supply to the baby.

Poor nutrition is another key factor. Inadequate intake of essential nutrients can result in maternal anemia and poor fetal growth, increasing the risk of preterm delivery.

High levels of stress—whether due to financial hardship, domestic challenges, or emotional trauma—can negatively affect pregnancy outcomes. Chronic stress may trigger hormonal responses that contribute to early labour.

In some communities, pregnant women continue performing strenuous labor late into pregnancy. Without adequate rest and medical supervision, the risk of complications rises. Women who do not attend regular antenatal clinics may miss early detection and treatment of conditions that could otherwise be managed effectively.

Crucial steps to reduce premature births

Although not all premature births can be prevented, many cases are avoidable through proper healthcare, education, and community support.

One of the most important preventive measures is attending antenatal clinics as soon as pregnancy is suspected. Regular check-ups allow healthcare providers to monitor blood pressure and blood sugar levels, screen for infections, detect anemia, provide nutritional supplements such as iron and folic acid, offer health education and counselling and consistent clinic attendance before and after delivery significantly improves outcomes for both mother and baby.

A balanced diet rich in proteins, vitamins, iron, and essential minerals supports healthy fetal development. Pregnant women should consume diverse foods, including fruits, vegetables, whole grains, and protein sources. Addressing anemia early through supplements and diet can lower the risk of premature birth.

Complete avoidance of alcohol, tobacco, and illicit drugs during pregnancy is critical. Public health campaigns continue to emphasize that there is no safe level of alcohol consumption during pregnancy.

Women with pre-existing conditions such as diabetes or hypertension should receive careful monitoring throughout pregnancy. Proper management reduces complications that could necessitate early delivery.

Communities and families play an essential role in supporting pregnant women. Reducing heavy workloads, promoting rest, and offering emotional support can contribute to healthier pregnancies.

Giving birth at a recognized health facility ensures access to skilled birth attendants and emergency care if complications arise. Home deliveries without trained personnel increase the risk of delayed intervention during premature labour.

Government efforts

Each year on November 17, countries observe World Prematurity Day to raise awareness and mobilize action. In Tanzania, the Ministry of Health has strengthened healthcare infrastructure by building specialized neonatal wards, procuring essential equipment, and training healthcare providers in advanced newborn care.

National surveys indicate gradual improvements in neonatal survival rates, aligning with the targets of the United Nations Sustainable Development Goals (SDGs). These global goals aim to reduce neonatal mortality to at least 12 deaths per 1,000 live births by 2030 and to end preventable newborn deaths.

Despite progress, sustained investment and community engagement remain essential. Preventing premature birth requires coordinated efforts—from policymakers and healthcare workers to families and community leaders.

A collective responsibility

Premature birth is not merely a medical issue; it is a social and developmental concern that affects families, health systems, and national productivity. While medical advances have saved countless young lives, prevention remains the most effective strategy.

By ensuring early antenatal care, improving maternal nutrition, discouraging harmful behaviours, and strengthening health services, communities can significantly reduce the number of babies born too soon. With collective commitment and continued investment in maternal and child health, the dream of giving every newborn a healthy start in life can become a reality.