As health systems struggle to care for all moms, U.S. preterm birth rate increased again in 2017 despite progress in some states
For the third year in a row, more U.S. babies were born too soon with serious risks to their health, according to the 2018 Premature Birth Report Card from March of Dimes, the nation’s leading maternal and infant health nonprofit. Premature birth and its complications are the largest contributor to death in the first year of life in the United States, and the leading cause of death of children under age 5 worldwide.
The overall U.S. preterm birth rate rose to 9.93 percent of births in 2017 from 9.85 percent in 2016, according to data from the National Center for Health Statistics (NCHS). While there is no single cause of preterm birth, research shows that chronic inequities and unequal access to quality health care do have a negative impact on these rates. These factors contribute to the reality that women of color are up to 50 percent more likely to deliver prematurely and their children can face a 130 percent higher infant death rate compared to white women. Promising interventions can help reverse these trends, and better access to health care is essential. A recent March of Dimes report revealed the unequal access to maternity care across the US, particularly in communities with higher poverty rates.
The continued rise in its preterm birth rate earned the U.S. a “C” grade on the March of Dimes Premature Birth Report Card, which grades all 50 states, DC and Puerto Rico on their preterm birth rate. This year, 30 states had a worse rate compared to last year and 10 of those states received a worse grade. The Report Card shows the racial, ethnic and geographic disparities in preterm birth within each state. (Visit March of Dimes to download broadcast-quality videos, high-resolution pictures, documents and other links about preterm birth.)
“We must all come together to take concrete, commonsense steps to reverse this alarming trend,” says Stacey D. Stewart, president of March of Dimes. “Our country’s most important resource is human potential. That begins with ensuring every baby has the healthiest possible start in life, regardless of racial and ethnic background or their family’s income. By expanding proven programs and innovative solutions we can shift our health care system to improve treatment and preventive care for moms and lower the preterm birth rate. Birth equity is our goal; it can be reached.”
The 2018 Report did show bright spots of progress in several states where a range of organizations, including the March of Dimes, have been able to reverse the trend and lower the preterm birth rate.
- Rhode Island: Increased leadership and collaboration among Rhode Island’s Department of Health, March of Dimes, and health care systems in the state led to a full percentage point drop in the premature birth rate and Rhode Island moving from a C to a B grade.
- Knox County, TN: Wider use of locally developed and tailored programs, such as group prenatal care, helped Knox County lower its preterm birth rate from 12.5% in 2007 to 9.8% in 2016, an improvement of more than 20% over the past decade.
- Raleigh, NC: Adoption of the North Carolina Pregnancy Medical Home model, which coordinates care for pregnant women, helped the city tackle early elective deliveries and smoking, forcing Raleigh’s preterm birth rate down from 9.9% in 2015 to 9.3% in 2016. Late preterm births also decreased from 6.9% to 6.1%.
While many of the underlying causes of preterm birth remain unknown, March of Dimes leads the fight for the health of all moms and babies by:
- Working to ensure women have access to preventive and supportive care before, during and after pregnancy.
- Delivering programs to improve the care that moms and babies receive. Group prenatal care can reduce health disparities, and March of Dimes is expanding its group prenatal care program, called Supportive Pregnancy Care,
- Empowering families and communities with the knowledge and tools to have healthier pregnancies.
- Supporting moms through every stage of the pregnancy journey, even when everything doesn’t go according to plan. The Share Your Story online community unites and supports families during their most vulnerable time. As families navigate the newborn intensive care unit (NICU), March of Dimes offers information and comfort with its NICU Family Support® program and its My NICU Baby™ App.
- Advancing research at our six Prematurity Research Centers. Experts study the causes of premature birth, knowing that the answers are going to involve a combination of interventions to prevent and solve this urgent health crisis.
- Advocating for policies to protect moms and babies and give them the best possible start.
- Amplifying the voices of all women and their families. We mobilize communities across the country to work toward achieving birth equity.
The March of Dimes Premature Birth Report Card is based on final 2017 natality data from NCHS. Compared to 2016, preterm birth rates in 2017 worsened in 30 states, stayed the same in 6 states and improved in 16 states.
- 1 state –Vermont– earned an “A” on the 2018 Premature Birth Report Card;
- 15 states received a “B”;
- 16 states got a “C”;
- 14 states, Puerto Rico and the District of Columbia got a “D”;
- 4 states (Alabama, Louisiana, Mississippi, West Virginia) received an “F.”
Among the 100 largest U.S. cities, based on the number of births in 2016, Irvine, California once again had the best (lowest) rate of preterm birth at 5.5 percent, and Detroit, Michigan now has the worst (highest) preterm birth rate at 14.5 percent.
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