Geneva, May 10 : India, Pakistan, Nigeria, China and Ethiopia together accounted for 45 per cent of all babies born early (before 37 weeks of pregnancy) in 2020, according to a new report released by UN agencies and partners on Wednesday. Raising alarm on a "silent emergency" of preterm birth, the report showed that an estimated 13.4 million babies were born pre-term in 2020, with nearly 1 million dying from preterm complications. This is equivalent to around 1 in 10 babies born early worldwide. The report Born too soon: decade of action on preterm birth, produced by the World Health Organization (WHO) and the Unicef together with PMNCH -- the world's largest alliance for women, children, and adolescents -- highlights long under-recognised problem of preterm birth in its scale and severity, which is impeding progress in improving children's health and survival. Overall, it found that preterm birth rates have not changed in any region in the world in the past decade, with 152 million vulnerable babies born too soon from 2010 to 2020. In 2020, Bangladesh had the highest estimated preterm birth rate (16.2 per cent), followed by Malawi (14.5 per cent) and Pakistan (14.4 per cent), India (13 per cent) and South Africa (13 per cent). Rates were also high in high-income countries, such as Greece (11.6 per cent) and the US (10.0 per cent). Southern Asia and sub-Saharan Africa have the highest rates of preterm birth, and preterm babies in these regions face the highest mortality risk. Together, these two regions account for more than 65 per cent of preterm births globally. "Ensuring quality care for these tiniest, most vulnerable babies and their families is absolutely imperative for improving child health and survival. Progress is also needed to help prevent preterm births -- this means every woman must be able to access quality health services before and during pregnancy to identify and manage risks," said Anshu Banerjee, Director for Maternal, Newborn, Child and Adolescent Health and Ageing at WHO, in a statement. Further the report said that preterm birth is now the leading cause of child deaths, accounting for more than one in five of all deaths of children occurring before their fifth birthday. Preterm survivors can face lifelong health consequences, with an increased likelihood of disability and developmental delays. Maternal health risks, such as adolescent pregnancy and pre-eclampsia, are also closely linked to preterm births. Gaping inequalities related to race, ethnicity, income, and access to quality care determine the likelihood of preterm birth, death, and disability, even in high-income countries. In addition, the impacts of conflict, climate change and environmental damage, Covid-19, and rising living costs are increasing risks for women and babies everywhere. For example, air pollution is estimated to contribute to six million preterm births each year. "After every preterm death is a trail of loss and heartbreak. Despite the many advances the world has made in the past decade, we have made no progress in reducing the number of small babies born too soon or averting the risk of their death," said Steven Lauwerier, Director of Health, Unicef, in the statement. "The toll is devastating. It's time we improve access to care for pregnant mothers and preterm infants and ensure every child gets a healthy start and thrives in life," he added. /IANS