If the U.S. was in school, it'd receive a "C" grade when it comes to preterm births, according to the latest March of Dimes report card. Prematurity had been on the decline for almost a decade, but it went up two years ago—and is continuing to rise. According to data from the National Center for Health Statistics, the rate of preterm births is now 9.8 percent, well above the March of Dimes' goal of 8.1 percent by 2020.
More than 380,000 babies are born prematurely (before 37 weeks) each year, upping their mortality risk in the first year of life. The latest increase means 8,000 more babies were born early than the year before. "The March of Dimes 2017 Premature Birth Report Card is a public wake-up call, an urgent call to action on the health of our nation's moms and babies," March of Dimes president Stacey D. Stewart tells Parents.com. "The U.S. preterm birth rate is among the worst of highly developed nations. This unacceptable trend requires immediate attention."
The latest statistics show that the preterm birth rate got worse in 43 states and improved in only four: Nebraska, New Hampshire, Pennsylvania, and Wyoming. Overall, four states got As, 13 got Bs, 18 got Cs, 12 got Ds and 5 got Fs. The March of Dimes also ranked the 100 U.S. cities with the greatest number of births, with Irvine, California, coming in at the lowest preterm birth rate (5.8 percent) and Cleveland, Ohio, ranking the worst (14.9 percent).
So why does the U.S. have such a dismal rating overall? "Many women do not get the care they need when they need it," Stewart says. "Preterm birth rates also increased across all racial groups in this country, which is something new and troubling this year." But black and Hispanic women, as well as lower income women and women in underserved geographic areas, are even more likely to deliver preterm. "The preterm birth rate among black women is 49 percent higher than the rate among white women," Stewart says.
Another contributing factor, Stewart says, is the age at which women are giving birth. For the first time, the birth rate among women 30 to 34 was higher than women 25 to 29. "The average age at first birth is also at a record high, and first birth rates have been increasing among women in their late thirties and forties and declining for women under 35 years," Stewart says. "Since women in their thirties are more likely than younger women to have health conditions that affect birth outcomes, such as diabetes, hypertension, and obesity, it's possible that this accounts for some portion—but not all—of the increase in premature birth."
In addition, Stewart says 45 percent of pregnancies in the U.S. are unplanned, and birth spacing at least 18 months apart reduces the risk of preterm birth. Elective, medically unnecessary early deliveries could also be a contributing factor. "It is possible that we are seeing some slippage in the efforts to ensure 39 or more weeks in healthy pregnancies, and we must stay vigilant," Stewart says.
Preterm birth is so dangerous for babies because it's associated with an increased risk of death—it's actually the largest contributor to infant death in the U.S. "In addition, babies who survive an early birth often face serious, lifelong health problems, including chronic lung disease, vision and hearing impairment, cerebral palsy, and neurodevelopmental disabilities," Stewart says. It's also responsible for $26 billion annually in medical costs, according to the National Academy of Medicine.
The March of Dimes is working to prevent preterm birth by supporting scientific research into its causes, educating women of childbearing age and healthcare professionals on best practices to reduce preterm delivery, and advocating for government policies that better support moms and babies.
What can pregnant women or women planning to become pregnant do to lessen their chances of delivering preterm? Stewart has some suggestions: