New Delhi, Oct 6 : India had 3·02 million preterm births in 2020 -- the highest worldwide, and accounting for over 20 per cent of all preterm births globally, according to a study published in the journal Lancet. The study by authors from the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the London School of Hygiene and Tropical Medicine, showed that over 50 per cent of all preterm births in 2020 occurred in just eight countries and areas. India was followed by Pakistan, Nigeria, China, Ethiopia, Bangladesh, Democratic Republic of the Congo, and the US. Although most of the high preterm birth rates occur in low-income and middle-income countries and areas, rates of 10 per cent or higher were also observed in high-income countries such as Greece (11·6 per cent ) and the US (10·0 per cent ). Globally an estimated 13.4 mn babies were born early (before 37 full weeks of pregnancy) in 2020 ' which is around 1 in 10 of all live births. Importantly, no region of the world significantly reduced rates of preterm births over the last decade. The annual global rate of reduction in preterm births between 2010 and 2020 was just 0.14 per cent. The agencies called for an urgent need to strengthen both care for preterm babies as well as prevention efforts -- particularly maternal health and nutrition -- as prematurity is the leading cause of death in children's early years. For those who live, preterm birth also significantly increases the likelihood of suffering major illnesses, disability and developmental delays, and even chronic diseases as adults like diabetes and heart conditions. "Preterm babies are especially vulnerable to life-threatening health complications and they need special care and attention," said Dr Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Ageing at WHO, in a statement. "These numbers show an urgent need for serious investment in services available to support them and their families as well as a greater focus on prevention ' in particular, ensuring access to quality health care before and during every pregnancy," she added. The paper derives estimates from population-based and nationally representative data to generate internationally comparable country-level estimates for 2020. As birth registration and facility-based deliveries have increased, data on the prevalence of preterm birth has improved. Gaps remain, however, with 92 countries lacking adequate nationally representative data. /IANS