SPEECH BY MDM RAHAYU MAHZAM, MINISTER OF STATE, MINISTRY OF DIGITAL DEVELOPMENT AND INFORMATION & MINISTRY OF HEALTH, AT THE APMCHC & IPRAMHO INTERNATIONAL MEETING 2026 ON PRETERM BIRTH

Associate Professor Chan Yoke Hwee, Chairman Medical Board, KKH

Dr Jason Lim, President, College of Obstetricians and Gynaecologists, Singapore

Professor Tan Kok Hian, Chairman, Organising Committee of the MCHRI & IPRAMHO International Meeting 2026 and President of the Perinatal Society of Singapore

Distinguished Guests

Ladies and Gentlemen

1.                Good morning.  I am pleased to join you this morning and I am heartened to see that the SingHealth Duke-NUS Maternal and Child Health Research Institute (MCHRI) continues to demonstrate its commitment in improving the health outcomes of women and children.

2.                Prof Chan has aptly shared KKH’s preterm birth prevention and management strategies. Today, I want to reflect on why this year’s theme on preterm birth represents not just a clinical imperative, but a fundamental commitment to our most vulnerable patients and their families.

The Global and Local Challenge of Preterm Births

3.       Preterm birth remains one of the most pressing challenges in maternal and child health worldwide. As the leading cause of deaths in children under the age of five years of age, it creates lasting impact on families all over the world.

4.       Even in countries with advanced healthcare systems, the numbers remain substantial. In Singapore, 2,873 babies were born preterm in 2024, representing a preterm birth rate of 8.5 per cent. This is a slight increase from 8.1 per cent in 2019, reflecting evolving social and clinical trends such as rising maternal age. While this increase may seem modest, it represents hundreds of families facing unexpected challenges and healthcare teams working tirelessly to ensure the best possible outcomes.

Current Knowledge Gaps and Need for Guidelines

5.       Preterm birth rarely has a single cause – it is typically multi-factorial. Despite decades of research and clinical advances, preterm births often remain unpredictable, especially when traditional risk factors, such as previous preterm birth or second trimester loss, are absent.

6.       For clinicians, this unpredictability underscores why standardised, evidence-based approaches are vital when managing such clinical complexity. A recent survey conducted by KKH revealed that whilst clinicians routinely assessed preterm birth risk, they report only moderate confidence in their screening practices, with considerable variation in approaches across practitioners. Furthermore, clinicians identified limitations in current screening tools available to them. These findings highlight the need for clear, consistent guidelines that empower clinicians to navigate these challenging situations with greater confidence and consistency.

7.       To address these issues, KKH led the establishment of a set of standardised, evidence-based frameworks for the Management of Preterm Birth, which includes screening strategies and management approaches. This set of guidelines, co-authored by clinicians both in the public and private sector, is endorsed by the College of Obstetricians & Gynaecologists, Academy of Medicine, Singapore.

8.       Developed using the current best evidence with expert consensus, these guidelines consider our local epidemiology, healthcare infrastructure, and multidisciplinary models of care. This underscores the strong commitment from all of you involved in the development of the guidelines which seeks to harmonise practice across the hospitals, reduce variation in care, and ensure consistent, evidence-based management regardless of where women seek care in Singapore.

Proactive Risk Assessment and Early Intervention

9.        For expectant parents, the first antenatal visit represents an important milestone in their pregnancy journey. Clear communication about how their pregnancy will be monitored and what support is available can help to address concerns and provide reassurance during this significant period.

10.     This is why one of the key clinical recommendations in the Guidelines seeks to shift away from the current approach of reactive management of complications towards a more systematic and proactive assessment of preterm birth risk. This involves conducting comprehensive risk assessments from the first antenatal visit, with enhanced monitoring at key gestational milestones and when clinical concerns arise.

11.     This systematic approach is particularly important, given that previous preterm birth history remains a significant risk factor for recurrence. Through early risk identification and appropriate monitoring protocols, healthcare teams can better support both mothers and babies throughout the pregnancy journey.

The need for continual research and collaborations

12.     Even as the guidelines will result in meaningful change in clinical practice, the work to address preterm births continues. Preterm birth remains a pressing healthcare challenge, with profound implications that extend well beyond the delivery room.

13.     As new evidence continues to emerge, we will need deeper insights into local risk factors and more targeted interventions that can be deployed at the right time for maximum impact. This is why conferences such as this one are so vital. By convening experts and sharing our experiences, the conference catalyses collaborations to improve and deepen the understanding of preterm birth management, drawing from the collective learnings from the local and international community.

Closing

14.     In closing, I applaud KKH and all partners for their dedication and commitment to evidence-based healthcare and partnership in advancing maternal and child health outcomes. Your work touches the lives of our most vulnerable patients at their most critical moments.

15.     I thank the international experts who have travelled here to share their expertise, and the local teams who continue to advance this critical field.

16.     This conference and the Guidelines launched today represent significant steps forward in our mission to improve outcomes for families everywhere. Together, we are building a future where every child has the best possible start in life.

17.     Thank you, and I wish you a productive and insightful conference.