For the second consecutive year, the United States earned only a "D" on the March of Dimes Premature Birth Report Card, demonstrating that more than half a million of our nation's newborns didn't get the healthy start they deserved.
In the 2009 Premature Birth Report card, seven states improved their performance by one letter grade and two fared worse. Criteria that affect preterm birth improved in many states:
• 33 states and the District of Columbia reduced the percentage of women of childbearing age who smoke;
• 21 states and the District of Columbia reduced the percent of uninsured women of childbearing age;
•27 states, the District of Columbia, and Puerto Rico lowered the late preterm birth rate.
As in 2008, no state earned an "A," and only Vermont received a "B." The grades were determined by comparing preterm birth rates to the national Healthy People 2010 preterm birth objective, which is 7.6 percent of all live births. The U.S. preliminary preterm birth rate was 12.7 percent in 2007.
"Although we don't yet understand all the factors that contribute to premature birth, we do know some interventions that can help prevent it, and we must consistently make use of all of these," said Dr. Jennifer L. Howse, President of the March of Dimes. She cited smoking cessation programs; health care before and during pregnancy; progesterone supplementation; and improved adherence to professional guidelines on fertility treatment and early Cesarean-sections and inductions.
According to the March of Dimes, quality improvement programs also are the key to lowering preterm birth rates. For example, the Intermountain Health Program in Utah reduced its elective C-sections to less than 5 percent from more than 30 percent. At Geisinger Health System in Pennsylvania, pregnant women are screened for chronic conditions and risks factors that can be treated proactively to lower the risk of preterm birth.