U.S. High on List of Preemie Births

Posted on May 4, 2012

Fort Myers News-Press May 2, 2012 NP staff

Dearth of prenatal care feared as cause;
SW Fla. numbers near national rate.

One in every eight babies in the U.S. is born prematurely, a number higher than in Canada, Australia or Japan, and worse even than rates in a number of less developed countries.

About 15 million premature babies are born every year — more than 1 in 10 of the world’s births and a bigger problem than previously believed, according to the first country-by-country estimates of this obstetric epidemic.

Most of the world’s preemies are born in Africa and Asia, said the report, released Wednesday.

The U.S. preterm birth rate is about the same as estimates in Thailand, Turkey and Somalia. In contrast, just 5.9 percent of births in Japan and Sweden are premature.

In Lee County, 837 of 6,449 recorded births in 2011 were premature, or about 13 percent, according to Florida Department of Health estimates. That’s slightly higher than the national rate.

In Collier, the number was 388 of 3,197 total births, or about 12 percent, the Department of Health data show.

The March of Dimes recently gave Florida a grade of “D” for its 13.5 percent rate of premature births. Roughly a third of the mothers had no health insurance, according to that report.

Experts can’t fully explain why the U.S. preemie rate is so much worse than similar high-income countries. But part of the reason must be poorer access to prenatal care for uninsured U.S. women, especially minority mothers-to-be, said March of Dimes epidemiologist Christopher Howson. African-American women are almost twice as likely as white women to receive late or no prenatal care, and they have higher rates of preterm birth as well, he said.

More disturbing for the Americans, the report ranks the U.S. with a worse preterm birth rate than 58 of the 65 countries that best track the problem, including much of Latin America. Add dozens of poor countries where the counts are less certain, and the report estimates that 127 other nations may have lower rates.

One key: not just early prenatal care but more preconception care, he said. Given that in the U.S. alone, almost half of pregnancies are unplanned, health providers should use any encounter with a woman of childbearing age to check for factors that could imperil a pregnancy.

According to the international report, the starkest difference between rich and poorer countries, however, is survival.

“Being born too soon is an unrecognized killer,” said Dr. Joy Lawn of Save the Children, who co-authored the report with the March of Dimes, World Health Organization and a coalition of international health experts. “And it’s unrecognized in the countries where you could have a massive effect in reducing these deaths.”

In the world, 1.1 million of these fragile newborns die as a result, and even those who survive can suffer lifelong disabilities.

Sophisticated and expensive intensive care saves the majority of preterm babies in the U.S. and other developed nations, even the tiniest, most premature ones. The risk of death from prematurity is at least 12 times higher for an African newborn than for a European baby, the report found.

Preemie risk factors

Scientists don’t know what causes all preterm births, and having one preemie greatly increases the risk for another. But among the risk factors:

  • Diabetes, high blood pressure, infections and smoking.
  • Being underweight or overweight, and spacing pregnancies less than two years apart.
  • Pregnancy before age 17 or over 40.
  • Carrying twins or more.
  • In wealthier countries, early elective inductions and C-sections.