Photo Credit: Alexandra Grablewski/The Image Bank/Getty Images
Almost a half a million babies are born prematurely each year in the United States, a number that puts the U.S. towards the bottom of a just-released report that looks at premature births around the globe.
According to Born Too Soon: The Global Action Report on Preterm Birth, the United States ranks a disappointing 131st, with a preterm birth rate that equals that of Somalia, Thailand and Turkey. Over a hundred nations, including Ecuador, Iraq, Cuba and Ethiopia, have better preterm birth rates than the United States.
The good news is that the premature birth rate is actually declining in the US. Currently, it's 12 births per 100 -- down from a high of 12.8 births per 100 in 2006. But that's still far too many early births, says Jennifer L. Howse, M.D. president of the March of Dimes. "The United States rate of preterm birth has been far too high for far too long," she says.
Preterm birth remains the leading cause of newborn death in the US, despite the fact that advancing technology now saves many babies who are born too soon. But given that fact that many preterm births are preventable -- the leading causes of prematurity are early elective delivery, infections, uncontrolled chronic medical conditions and pregnancy with multiples -- Dr. Howse and other medical experts say it's time for the US to turn its attention towards preventing premature birth. Proven anti-prematurity interventions include:
Access to healthcare. Pre-conception and prenatal care can drastically reduce the number of preterm births. Good prenatal care includes screening for infections that, if left untreated, can cause preterm birth. Prenatal care also helps women manage chronic conditions such as diabetes and high blood pressure, and may provide emotional and social support that can help reduce a woman's risk of preterm birth.
Behavorial changes. Smoking increases the risk of preterm birth. So does drinking alcohol. Interventions to support smoking cessation and drug and alcohol abstinence may help decrease preterm births.
Progesterone treatment for women who have had prior preterm births. Administering progesterone to pregnant women who have already had at least one preterm birth may increase their chances of carrying to term.
Better management of fertility treatments. Being pregnant with two, three, four or more babies simultaneously increases the risk of preterm birth, and the risk increases with the number of fetuses.
Waiting until at least 39 weeks to deliver, if possible. Recent research shows that babies' organs continue to develop throughout pregnancy, and that being born even a few weeks too early (say, at 37 weeks instead of 39 or 40) can cause health problems. While some early inductions and C-sections are necessary for medical reasons, doctors and hospitals now strongly discourage non-medically necessary C-sections or inductions before 39 weeks of pregnancy.
The United States government is paying attention to prematurity -- and hopefully the efforts will pay off. In February 2012, the Department of Health and Human Services announced the Smart Start initiative, which will provide funding and support to reduce the preterm birth rate. With any luck, the rate will continue to decline – and by 2020, may even reach 11.4 percent, the goal set by HealthyPeople2020.