Slight Improvements in Preterm Birth Rates

U.S. Still Behind Other Industrialized Countries

Reviewed by Laura J. Martin, MD on November 17, 2010
From the WebMD Archives

Nov. 17, 2010 -- A state-by-state review of preterm birth rates saw some slight improvements, but the United States overall still has a long way to go to meet the nation’s Healthy People objective of 7.6%, according to a report released by the March of Dimes.

States Still Fail to Make Higher Grades

The nation’s preterm birth rate fell from 12.7% in 2009 to 12.3% in 2010. The states that did improve only showed slight declines in preterm birth rates. Overall, 17 states earned a “C,” 20 received a “D,” and 13 states, the District of Columbia, and Puerto Rico failed. Regionally, many of the “Fs” occurred in the South, whereas the West Coast and Northeast had predominantly “Cs.” Not a single state earned an “A” or a “B.”

Some states that demonstrated significant improvement include Wyoming, which went from a preterm birth rate of 12.7% in 2009 to 11.2% in 2010; Colorado, which went from 12.2% to 11.4%; and Virginia, which went from 12.1% to 11.3%. States also experienced decline, including Vermont, which went from a grade of “B” in 2009 to a “C” in 2010.

Despite many states failing, states did improve their rates of preterm births by making a dent in the problem. Smoking and lack of health insurance both increase the risk of preterm birth. Among the improvements:

  • 28 states and Puerto Rico reduced the percentage of women of childbearing age who smoke.
  • 17 states and the District of Columbia lowered the number of uninsured women of childbearing age.

37 states and Puerto Rico reduced the preterm birth rate of infants born between 34 and 36 weeks; 79 % of the national rate of decline occurred among babies born just a few weeks too soon.

National Rate Improves Slightly

The March of Dimes says these numbers indicate a start of an upward trend. Preterm birth rates had been steadily rising until between 2006 and 2008 when the rate dropped from 12.8% to 12.3%, respectively. The March of Dimes notes that despite its wealth, the United States has a high rate of preterm birth compared with other 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,” Jennifer L. Howse, PhD, president of the March of Dimes, says in a news release. “The two-year decline we have seen nationwide, though small, is 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.”

The report’s findings were released on the 8th Annual Prematurity Awareness Day and also when U.S. Surgeon General Regina M. Benjamin, MD, introduced a new public service awareness announcement about preterm birth. “As a family doctor, I’ve seen the terrible impact of premature birth,” Benjamin says in a news release. “It can cause life-long disabilities, and it is the leading cause of deaths in newborns. Our country has one of the highest rates of preterm birth in the world. We have to do better.”

A Global Problem

Worldwide, an estimated 13 million babies are born premature or before 37 weeks' gestation and 1 million die as a result of an early birth. In the U.S., more than a half million babies are born premature every year. Premature birth is the leading cause of newborn death, and those infants who survive face a risk of several disabilities, including respiratory problems, developmental problems, cerebral palsy, and learning disabilities.

The final weeks of pregnancy are critical because an infant’s organs aren’t fully developed until after 37 weeks' gestation. The March of Dimes recommends reducing the risk of premature birth by increasing preconception and prenatal care, reducing smoking, avoiding multiples from fertility treatments, and avoiding unnecessary cesarean deliveries and inductions before 39 weeks of pregnancy.