article · International Journal of Gynecology & Obstetrics
Preterm birth is the leading cause of mortality among children under five years old and significantly reduces quality-of-life adjusted years globally. Although numerous care bundles exist to mitigate these impacts, many are unsuitable for low-resource environments. The FIGO PremPrep-5 initiative addresses this by identifying and promoting five simple, cost-effective, and clinically proven interventions that healthcare providers can implement in almost any setting. These key measures comprise antenatal corticosteroids prior to delivery, intrapartum magnesium sulphate, delayed cord clamping during delivery, early feeding with maternal breast milk, and immediate kangaroo mother care postnatally. These baseline practices can be integrated easily into routine maternal and neonatal healthcare and supplemented with advanced medical care where available. The initiative supports global implementation through educational resources, including instructional videos and infographics.
Preterm birth severely threatens infant survival and long-term development, yet many advanced treatments remain out of reach in resource-limited clinics. Highlighting five affordable, high-impact clinical practices enables frontline healthcare workers worldwide to deliver life-saving care immediately. This standardized approach helps bridge healthcare disparities and reduce preventable infant deaths without requiring complex or prohibitively expensive medical infrastructure.
The initiative offers immediate real-world utility for maternity clinics, hospitals, and clinical training programmes. Although primarily a public health and guideline framework rather than a proprietary commercial product, the educational tools, such as videos and infographics, are already prepared for deployment. Digital health platforms, medical training providers, and healthcare organisations can adopt these materials immediately to support workforce education and standardise neonatal care protocols across varied clinical environments.
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Preterm birth remains the leading cause of mortality among under-5's and is a major contributor to the reduction in quality-of-life adjusted years and reduction in human capital. Globally, there are many interventions and care bundles that aim to reduce the impact of preterm birth once preterm labor has ensued and into the neonatal period; not all of these are applicable in all settings. Here, we introduce the FIGO PremPrep-5 initiative, which aims to disseminate key information on the most simple and effective interventions with the aim of increasing implementation globally. Before delivery, we recommend a course of antenatal corticosteroids, and intrapartum magnesium sulfate. At delivery, we recommend delayed cord clamping. Postnatally, we recommend early feeding with breast milk and immediate kangaroo care. While there are many other interventions that may improve outcomes at the time of labor and after preterm birth, these are clinically effective and relatively inexpensive options that can be practiced in most settings and supplemented with more advanced care. We include examples of a training video and infographics that will be used for dissemination.
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DOI: 10.1002/ijgo.15269
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