A nationwide effort to reduce U.S. preterm births to 5.5 percent of all live births by 2030 has been urged by a March of Dimes report.
Seven other developed countries already have preterm birth rates below 6 percent, and 15 have rates below 7 percent.
The U.S. rate of 11.4 percent in 2013 is one of the highest. The U.S. ranked 37th out of 39 high resource countries in 2010.
"The United States spends more money per capita on health care than almost any other country in the world, and yet our premature birth rate and our infant mortality rate are among the highest." says Dr. Jennifer L. Howse, president of the March of Dimes. "The U.S. should aspire to be among the best globally in preterm birth rates and give all our children a healthy beginning."
Writing in an article in Pediatrics
published online today, Dr. Howse and her coauthors assert that the goal can be achieved by optimal use of known interventions and by studying countries with better outcomes. Interventions and risk reduction strategies known to prevent premature birth include:
Eliminating early elective deliveries before 39 weeks of pregnancy•
Optimizing birth spacing (18-23 months between pregnancies)•
Helping women quit smoking•
Offering progesterone treatments for all women with a prior preterm birth•
Reducing multiple births by following fertility treatment best practices•
Offering low-dose aspirin to prevent pre-eclampsia in women with high risk pregnancies.
The authors also call for expanded funding for research to discover the unknown causes of premature birth and identify new interventions. The March of Dimes is funding a network of Prematurity Research Centers that currently include Stanford University, and a consortium of universities in Ohio including University of Cincinnati, The Ohio State University, and Case Western Reserve University. Two new research centers will be announced later this month.
Premature birth (before 37 completed weeks of pregnancy) is a serious health problem that costs the United States more than $26 billion annually, according to the Institute of Medicine. It is the leading cause of newborn death. Babies who survive an early birth face a higher risk than babies born full term of lifetime health challenges, such as cerebral palsy, visual and hearing impairments and intellectual disabilities.
About 450,000 babies were born too soon in 2013 in the United States out of nearly four million live births. Had the US achieved a rate of 5.5 percent in 2013, the number of babies born preterm could have been reduced by half. A rate of 5.5 percent would move the U.S. ranking to the top 10 percent of high resource countries.