Rate of Premature Births in US Infants Falling

After rising steadily for three decades, the rate of US infants born prematurely dropped for the second straight year, from 12.8% in 2006 to 12.3% in 2008, according to a report from the March of Dimes, which states that 79% of the decline was among infants born just a few weeks too soon.

Although the drop was slight, health experts said it was significant, according to an article published in USA Today. “We’ve still got a lot of work to do, but it's starting to get better,” said Jennifer L. Howse, PhD, president of the March of Dimes, noting that the 2008 rate is still far above the 2010 national goal of 7.6%.

In the 2010 March of Dimes Premature Birth Report Card, eight states earned a better grade than in the last report, and 32 others and the District of Columbia saw their preterm birth rates improve.

However, overall, the US received a “D” on the report card, which measures national preterm birth rates against the Healthy People 2010 goals. The US, according to the March of Dimes, has a high rate of preterm birth compared to top scoring states and, notably, most industrialized countries.

“The policy changes and programs to prevent preterm birth that our volunteers and staff have worked so hard to bring about are starting to pay off,” said Howse in a statement. “The two-year decline we have seen nationwide, though small, are encouraging. We believe this decline is the beginning of a trend, but must be supported by better health care, new research and adoption of intervention programs to lower the risk of preterm birth.”

As a family physician, US Surgeon General Regina M. Benjamin has seen “the terrible impact of premature birth. It can cause life-long disabilities, and it is the leading cause of deaths in newborns,” she said. “Our country has one of the highest rates of preterm birth in the world. We have to do better.”

In the US, more than half a million babies are born preterm each year, which costs the nation’s health care system more than $26 billion annually, according to the Institute of Medicine. It is the leading cause of newborn death, and those who survive an early birth often face the risk of lifetime health challenges, including breathing problems, cerebral palsy, and intellectual disabilities. Even infants born just a few weeks early have higher rates of hospitalization and illness than full-term infants.

On the 2010 report card, 17 states earned a “C,” 20 received a “D,” and 13 states, the District of Columbia and Puerto Rico failed. However, most states saw improvement in at least one of the three contributing factors the March of Dimes tracks.

• 28 states and Puerto Rico reduced the percentage of women of childbearing age who smoke;
• 17 states and the District of Columbia reduced the percentage of uninsured women of childbearing age;
• 37 states and Puerto Rico lowered the late preterm birth rate, infants born between 34 and 36 weeks gestation.

There are known strategies that can lower the risk of an early birth, such as smoking cessation, preconception care, early prenatal care, progesterone treatments for women with a history of preterm birth, avoiding multiples from fertility treatments and avoiding unnecessary c-sections and inductions before 39 weeks of pregnancy, according to the March of Dimes, which offers a number of programs and best practices to support health care professionals and consumers to address preterm birth, including:

• Healthy Babies Are Worth the Wait—a community-based pilot project of health promotion and prematurity prevention
• The “Elimination of Non-medically Indicated (Elective) Deliveries before 39 Weeks Gestational Age” tool kit
• The Preterm Labor Assessment kit, which provides guidance for standardized assessment and diagnosis of preterm labor by health care professionals

Do you think that enough is being done to prevent premature births in the US? Why does a country as developed as the US still lag behind in this area?