U.S.’s Report Card on Premature Births: An “A” for Effort, but “C” Overall

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For six consecutive years, the U.S. has successfully lowered the rate of preterm births, to 11.5%. But that still falls short of the March of Dimes goal.

The nonprofit organization, which leads the Prematurity Campaign to improve the health of mothers and babies by educating women about the risk factors for preterm birth, hopes to lower the premature birth rate in the U.S. to at least 9.6% by 2020.

Each year, the March of Dimes issues a Premature Birth Report Card that grades each state on its efforts to lower premature births. The U.S. earned a “C,” but six states made significant enough improvements to earn an A — Alaska, California, Maine, New Hampshire, Oregon and Vermont. The states with the highest premature births rates included Alabama, Louisiana, Puerto Rico and Mississippi, which all received an “F.”

(MORE: New (And Hopefully Improved) Definition of Term Pregnancy)

The national preterm birth rate peaked in 2006  at 12.8%, after steadily rising for more than 20 years. Prematurity is linked to a series of health issues for babies that can extend into childhood and beyond. Preterm babies are more likely to develop neurological conditions and have lower IQ in school, and they also have a higher risk of heart and breathing problems. But due to greater awareness of the dangers of preterm birth, and effective interventions from major medical and physician groups to help women deliver at term, the rate has since dropped by 10%. According to the data, about 176,000 fewer babies have been born preterm — or before 39 weeks gestation — since 2006, which the March of Dimes says saved about $9 billion in health and societal costs.

What is helping more mothers to deliver at term? One of the biggest factors is a decline in the number of women who choose to deliver before 39 weeks of pregnancy. The American College of Obstetricians and Gynecologists’ (ACOG) recently issued new definitions of early term and full term pregnancy, in order to help doctors and expectant moms to understand the importance of waiting until their baby is fully developed before delivering.

California, which received an “A” for having a preterm birth rate of 9.6%, developed a tool kit for its hospitals that provides physicians with guidelines and educational materials to provide mothers informing them of the risks of early delivery. According to the March of Dimes, about 20% of late preterm births, which occur between 34 and 37 weeks of pregnancy, could be avoided with such programs that encourage women to wait, and give them the support they need, throughout their pregnancy, to do so.

(MORE: Finally, The First Home Pregnancy Test That Tells You How Pregnant You Are)

Despite these successes, however, most states were behind in meeting the March of Dimes’ goal. Too many women still aren’t insured, which keeps them out of prenatal care that can help them to avoid early delivery, and too many expectant mothers still smoke and engage in other behaviors that increase their risk of not being able to have a term pregnancy. “Although we have made great progress in reducing our nation’s preterm birth rate from historic highs, the US still has the highest rate of preterm birth of any industrialized country. We must continue to invest in premature birth prevention because every baby deserves a healthy start in life,” said March of Dimes President Dr. Jennifer L. Howse, in a statement. “A premature birth costs businesses about 12 times as much as uncomplicated healthy birth.” Bringing rates down, then, will promote better health and lower health costs for the next generation.