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Preterm Birth Was Leading Cause of Mortality, at 18%, for Children Under the Age of 5 in 2019, New Estimates Show

Almost half of total under-5 deaths were caused by infections, many vaccine preventable

A new study led by Johns Hopkins Bloomberg School of Public Health researchers estimates that the number of deaths of children under five decreased from nearly 10 million in 2000 to 5.3 million in 2019. Despite this dramatic decline, deaths from preterm birth still account for 0.9 million deaths, or 18% of deaths overall, up from 14% in 2000. Infections that are vaccine preventable or treatable at low cost continue to account for more than 2 million under five deaths.

The study, published November 16 in The Lancet Child and Adolescent Health, was led by Jamie Perin, PhD, MS, associate scientist in the Bloomberg School’s Department of International Health, and Li Liu, PhD '08, MHS '06, associate professor in the Bloomberg School’s Department of Population, Family and Reproductive Health. 

These latest estimates provide new information about the causes of child mortality in countries that do not have the resources to collect national-level data on causes of death. Findings include

  • Globally, complications due to preterm birth are the top contributor to mortality for children under five at 18%.
  • Lower respiratory infections are also a leading cause of mortality for children younger than five, at 14%. 
  • Intrapartum-related events are the third leading cause of mortality globally for children younger than five, at 12%. 
  • Almost half of mortality for children under five is caused by infections (49%), and 22% by vaccine preventable infections.  

Despite the reduction in total deaths, the global under-5 mortality rate is still 38 deaths per 1,000 live births—well above the U.N.’s target of 25 per 1000 as established by the Sustainable Development Goals, which were adopted by all U.N. Member States in 2015. Data from 2020 are still being analyzed.

Global, regional, and national causes of under-5 mortality in 2000–19: an updated systematic analysis with implications for the Sustainable Development Goals was written by Jamie Perin, Amy Mulick, Diana Yeung, Francisco Villavicencio, Gerard Lopez, Kathleen L Strong, David Prieto-Merino, Simon Cousens, Robert E Black, and Li Liu.