An Overview of Neonatal Outcomes and Current Preterm Immunization Practices in India: An Expert Consensus

IntroductIonPreterm birth (PTB) is defined as a newborn delivered before 37 weeks of gestation.It is one of the most significant factors influencing adverse birth outcomes. 1It is also the primary cause of neonatal mortality, accounting for over 75% of deaths in the first month of life. 2 The Sustainable Development Goals (SDGs) aim to decrease neonatal and under-five mortality to 12 per 1,000 and 25 per 1,000 live births, respectively, by 2030. 1 Preterm infants are more susceptible to hospitalization and mortality resulting from vaccine-preventable diseases (VPDs). 3 This can be minimized by employing adequate and effective immunization. 1However, in actual practice, immunization is delayed despite the Indian Academy of Pediatrics (IAP) guidelines in place.This exposes preterm infants to an increased risk of infections, comorbid conditions, and death. 3 Vaccine delays are mainly caused by concerns of parents and healthcare providers (HCPs) about their need, effectiveness, and safety. 3These delays could be avoided by discussing immunization with both HCPs and parents, as well as by establishing clear and robust immunization guidelines for preterm infants. 4 The objective of this review is to understand the preterm immunization practices in India and the need to implement standardized guidelines, as well as to establish the significance of hexavalent vaccines for preterm infants.