The report card for preterm births across the world doesn’t show the U.S. ahead of the curve. In fact, preterm births are the leading cause of newborn death in the U.S.
With almost half a million babies born early at a rate of 12 preemies in every 100 live births, the U.S. is ranked 131st in the world in terms of its preterm birth rate, according to a new report.
The report, entitled Born Too Soon: The Global Action Report on Preterm Birth, was a joint research project with collaboration from the March of Dimes, The Partnership for Maternal, Newborn & Child Health, Save the Children and the World Health Organization.
In terms of straight numbers, the U.S. ranks sixth in preterm births, though this is due in large part to the large population.
Worldwide, 15 million babies are born early, and more than a million die from complications related to preterm birth, defined as being born more than 37 weeks of pregnancy.
Preemies tend to face greater health risks and chronic health problems in a range of areas than babies born at full term. These health problems can include long-term disability, serious infections, cerebral palsy, brain injury, and various respiratory, vision, hearing, learning and development problems.
“Treating premature infants is like trying to stop a snowball once it’s 99 percent of the way down the mountain and has become an avalanche,” said Craig Rubens, MD, a contributor to the report and the executive director of the Global Alliance to Prevent Prematurity and Stillbirth.
“The emphasis needs to be on prevention strategies that work everywhere, especially in low-resource, high-burden settings,” Dr. Rubens said.
Because of the greater medical and health needs of preemies, the Institute of Medicine estimates that over $26 billion is spent annually related to early births.
According to Dr. Jennifer Howse, president of the March of Dimes, there are a range of health interventions that can help reduce the preterm birth rate in the U.S., starting with adequate access to quality healthcare to all women of childbearing age in the U.S.
Women who receive regular prenatal care are less likely to have a preterm birth, and they can reduce their person risk further by avoiding certain activities and lifestyle choices, such as smoking while pregnant.
Women who have already had one preterm birth, Dr. Howse said, can take progesterone treatments to lower their risk of having another preemie.
On the larger scale, the medical establishment can take measure to lower the rate of preterm births, including managing fertility treatments better so that multiple births, such as twins and triplets, are less likely, Dr. Howse recommended.
Another step doctors and hospitals can take, Dr. Howse said, is to institute procedures to ensure that pregnancy induction and cesarean sections are not given to women before 39 weeks of gestation unless they become medically necessary.
“This report offers conclusive evidence that the United States rate of preterm birth has been far too high for far too long,” Dr. Howse said. “While our country excels in helping preemies survive, we have failed to do enough to prevent preterm births and help more mothers carry their babies full-term.”
The U.S. Department of Health and Human Services partnered with the March of Dimes in February on a joint campaign called “Healthy Babies are Worth the Wait,” encouraging women to wait for natural labor to begin on its own if they have an healthy pregnancy.
Over 3 percent (1 out of 33) babies born in the United States has some kind of birth defect. Many are genetic and could not have been prevented, as the cause of up to two thirds of all birth defects are unknown. However, many common birth defects are also preventable. The focus of prenatal care is to ensure that mother and baby are both healthy during pregnancy, as well as preventing and treating any looming birth defects and health problems.
The most common preventable birth defects are cardiac (1 out of every 100-200) which can range from common defects of the inner walls of the heart to very severe arterial problems that require emergency surgery or transplants. Also common are neural tube defects (1 out of every 1000) which commonly result in spina bifida (a defect of the spinal cord) and anencephaly (incomplete formation of the brain. These are less common but serious problems that can result in significant sickness and death for the child. While rare, genetic defects in utero can result in several different genetic disorders, including Down’s syndrome, Prader-Willi syndrome, Turner’s syndrome, and many others.