Report Finds High Rate Of Preterm Births, Calls For Improved Prenatal Care

Main Category: Pediatrics / Children's Health
Also Included In: Pregnancy / Obstetrics;  Women's Health / Gynecology
Article Date: 13 Nov 2008 - 7:00 PST

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The March of Dimes on Wednesday released its first state-by-state "Premature Birth Report Card," urging states to address factors that contribute to the country's high premature birth rate, USA Today reports. The report -- which gave the U.S. an overall grade of 'D' -- examined data on the percentage of 2005 live preterm births, defined as births before 37 weeks' gestation. The report ranked Vermont at the top of the list with a 9% rate of preterm births and Mississippi at the bottom with 18.8%, USA Today reports (Rubin, USA Today, 11/12).

According to the AP/Denver Post, the data show that the rate of preterm births "steadily worsens" moving from the northern states to the southern states (Neergaard, AP/Denver Post, 11/12). Gina Fiorentini-Wright of the Southern Mississippi Area Health Education Center at the University of Southern Mississippi-Hattiesburg said "poverty and not having insurance and not having prenatal care probably plays a big part" in Mississippi's high preterm birth rate. Robert Young, director of obstetrics and gynecology at the University of Vermont, said several factors have helped Vermont maintain a steady preterm birth rate while the rest of the nation's has risen. Young said that "you really can't ignore the fact that we have a high number of insured," adding that improvements in measuring quality of prenatal care also have been a factor.

Recommendations

Jennifer Howse, president of the March of Dimes, said that additional research into the causes of preterm birth is needed but added that the group "believe[s] that there are some solutions that are at hand," including expanding state health insurance coverage to ensure proper prenatal care for women and giving women with previous preterm deliveries weekly shots of the hormone progesterone beginning at 16 to 20 weeks' gestation (USA Today, 11/12).

The report also suggested that states take steps to reduce smoking by all women of childbearing age. Government data suggest that about 17% of women smoke during pregnancy, which can contribute to low birthweight, prematurity and birth defects. According to the report, about one-third of pregnant women smoke in Louisiana -- which had a preterm birth rate of more than 16% -- and West Virginia -- which had a rate of 14.4%. According to the AP/Post, the report also suggested that states address the "trickier" issue of "late" premature births -- infants who are born between 34 and 37 weeks' gestation, which can lead to learning or behavioral delays and other problems. Recent research suggests late premature infants usually are delivered by caesarean sections scheduled before 37 weeks, either

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