Premature Births May Be Inching Down, But Still a Big Problem Worldwide

WASHINGTON — Premature births may finally be starting to inch down, says a new report from the March of Dimes.

The change is small: In 2006, 12.8 percent of U.S. babies were born premature, compared with 12.3 percent in 2008.

Still, that translates into 21,000 fewer preterm births, said March of Dimes president Dr. Jennifer Howse – what she called the first real sign of progress after three decades of rising prematurity.

"That was very welcome news," Howse said. "What we think is happening is that the message is really getting across that every week of pregnancy counts."

That's because most of the improvement came among babies born just a few weeks early. Howse credited efforts to clamp down on doctors and hospitals that were scheduling elective deliveries – inductions or first-time C-sections – too soon, despite guidelines discouraging such deliveries until completion of 39 weeks of pregnancy.

More than half a million U.S. babies are born premature each year, and 13 million worldwide. A baby born before completion of 37 weeks is termed premature. Those born very early face the greatest risk of death and lifelong health problems. But being born even a few weeks early can lead to breathing problems, jaundice and learning or behavioral delays.

The nation is nowhere near meeting the government's goal: That no more than 7.6 percent of babies be born preterm.

"Our country has one of the highest rates of preterm birth in the world," U.S. Surgeon General Regina Benjamin said in a statement. "We have to do better."

Wednesday's March of Dimes report maps state-by-state disparities in prematurity. The odds of having a premature baby were lowest in Vermont – where 9.5 percent of births were preterm in 2008 – and highest in Mississippi, with a rate of 18 percent, the report found.

Doctors don't know all the causes of preterm birth. But stopping smoking and getting early prenatal care can lower a woman's risk. The new report found that while smoking by pregnant women is declining slightly, the poor economy left more women without insurance in 2008.

Howse said the new health care law should help improve women's access to early prenatal care in coming years, including by eliminating pregnancy as a preexisting condition starting in 2014, but called for additional efforts to battle the problem.

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Online:

March of Dimes: http://www.marchofdimes.com

Comments

[Heather Irw]

07:52 PM on 12/21/2010

Prenatal care, and avoiding things such as smoking, alcohol and other drug use is only a portion of the problem. There are other issues in pregnancies, such as Pre-Eclampsia for instance, and other non related issues to health care and substance abuse that cause PTL. However, things such as PreE can be monitored better, with proper health care. This does not always fix the issue. I delivered my son at 25 weeks, had fantastic health care, and a team of specialist that did everything they could. Beyond that, I was a model pregnant women. Taking my vitamins, light work outs, and avoiding bad foods, and consuming the good. There are other health conditions that cause PTL, and frankly.. I would like to see more research in that. Yes, I think pregnant women having access to care is key, and education as well. But there are bigger issues out there, that are more of the "unknown" that bring just as scary and equally risky issues.

[Martin 27514]

06:35 PM on 11/17/2010

Infection - often with opportunist organisms - is associated with PTL. There will be multiple causes.

Teenage women with a prior history of PTL, who are smokers, cocaine users, single, unemployed, with poor diets etc are most afflicted i.e they are susceptible to opportunist infection. One unstudied potential cause are denervatory injuries to the vaginal mucosa. We know that denervation changes the susceptibility of a mucosal membrane from pathogenic organisms to opportunist organisms. It may explain the high recurrence rates, etc ?

None of the associations of PTL are decreasing, it seems slightly optimistic to believe that PTL rates are decreasing when they have been going up relentlessly for thirty years ?

[AngelaQuattrano]

01:57 PM on 11/17/2010

It is unlikely that the band-aid health insurance reform bill will have much of an effect on this. Pregnant women will still be unable to afford insurance, only now they'll be fined for not paying much of their income as premiums. So they'll be paying a fine instead of buying food. That will help them get medical care.