March of Dimes’ Report Card Gives U.S. ‘D’ Grade for Preterm Birth Rate

The March of Dimes in its first state-by-state "Premature Birth Report Card" graded the U.S. a "D" overall, USA Today reports. According to the report card, which was released on Wednesday, the U.S. preterm birth rate was 12.7% in 2005, compared with 11% in 1995. Vermont had the lowest rate of preterm babies at 9%, while Mississippi had the highest rate with 18.8% of babies born preterm. No state received an "A" grade, which required a preterm birth rate of 7.6% or less -- the government's "Healthy People 2010" goal (Rubin, USA Today, 11/12). The report card found that preterm birth rates were higher in southern states (AP/Arizona Daily Star, 11/12).

March of Dimes President Jennifer Howse said that more research needs to be conducted on the causes of preterm birth but "we believe that there are some solutions that are at hand" (USA Today, 11/12). The report calls on states to address factors that play a role in preterm births, including a lack of health insurance among women, which leads to missed or late prenatal care. According to the report card, in states with the highest rates of preterm birth, one in five women of childbearing age are uninsured (AP/Arizona Daily Star, 11/12).

Roger Young, a March of Dimes board member and director of obstetrics and gynecology at the University of Vermont, said that "you really can't ignore the fact that [Vermont has] a high number of insured patients," adding that the state's system of measuring the quality of prenatal care also has helped keep its preterm birth rates low. Gina Fiorentini-Wright of the Southern Mississippi Area Health Education Center at the University of Southern Mississippi said that "poverty and not having insurance and not having prenatal care probably plays a big part" in Mississippi's high preterm birth rate.

The report also recommends that women who have had previous preterm births receive weekly hormone shots, which research has shown could reduce preterm birth risk by 33%, and that hospitals review the reasons for labor inductions and caesarean sections before 39 weeks' gestation, as studies have found that some are scheduled early for the doctor's and/or mother's convenience (USA Today, 11/12). In addition, the report calls on states to target smoking among all women of childbearing age because smoking increases the risk of preterm birth (AP/Arizona Daily Star, 11/12).

Young notes that "the goal is not preterm birth reduction, period. The goal is healthy babies," adding that nothing would be accomplished if the preterm birth rate falls but stillborn birth rates rise because of babies in distress not being delivered quickly enough (USA Today, 11/12).

The report card is available online.