KOLLAM: Kerala, which is praised for its robust healthcare system, is now facing a troubling trend: a steep surge in preterm births. The number of preterm newborns in the state jumped from 6,916 in 2017-18 to 26,968 in 2023-24, a staggering 289% increase over seven years, according to data from the Health Management Information System (HMIS).
The rise comes even as the total number of live births has declined — from 4.93 lakh in 2017-18 to 3.74 lakh in 2023-24.
Also, the increase has been steady. Preterm births climbed to 13,077 in 2018-19, marking an 89% increase in just one year. Since then, the upward trend has continued.
Health experts link this alarming increase to deteriorating lifestyle patterns, which have led to a rise in conditions such as hypertension, obesity and diabetes among women of reproductive age. According to experts, advancements in neonatal care technology have made preterm births more acceptable to both doctors and patients.
However, they caution that while such interventions can save lives, they come with significant risks.
“Preterm births, especially those that are iatrogenic (medically induced) have become far more common for reducing maternal complications. This reflects a worrying trend where pregnant women are increasingly affected by lifestyle diseases, which, in turn, lead to complications during pregnancy,” said Dr Lalithambica, senior gynaecologist and former head of the department at Government Medical College, Alappuzha.
Preterm babies are more vulnerable to neurological disorders, says doc
She said induced preterm births are particularly on the rise among women aged between 30 and 40, who often delay pregnancy due to career or personal choices.
“These women are more likely to develop hypertensive disorders and gestational diabetes and fetal growth restriction, which may necessitate early delivery,” she said.
“Spontaneous preterm births, on the other hand, often occur due to cervical insufficiency, maternal stress or poor maternal weight gain. However, with proper maternal care and treatment, the risk of spontaneous preterm birth can be reduced in subsequent pregnancies. Preterm birth is expensive and puts families under severe financial pressure,” she said.
Dr Lalithambica also warned that the growing reliance on advanced neonatal care has fostered a false sense of security.
“Many private hospitals claim they can save babies delivered as early as 22 weeks. While technology has improved the survival of neonates, it does not eliminate long-term risks. Preterm babies are more vulnerable to neurological disorders, both immediate and long-term, gastrointestinal complications, visual and hearing impairments, and learning and academic inefficiencies,” she added.
Dr Pandu R, a senior gynaecologist based in Kannur, said part of the issue stems from growing mistrust between patients and doctors.
“Many patients request early delivery out of fear or misinformation, often under pressure from bystanders.
Doctors, in turn, may comply out of fear of legal consequences. If one doctor refuses, patients simply go elsewhere,” he said.
He stressed the urgent need for awareness and education.
“Medical professionals must take responsibility for educating both patients and families about the risks of preterm delivery and the complications involved in pregnancy. Restoring trust between patients and healthcare providers is essential to reversing this trend,” he said.