"Overall, it's a very important point that the March of Dimes is making," Perl said. "We have to look not only at how well we take care of our premature babies, but what we can do to prevent mothers from having premature babies."
The report didn't explore some significant geographic variations in causes for preterm birth factors that need to be considered when designing education or intervention programs, Perl said. New Jersey and Missouri, for example, had roughly the same rate of premature births, 12.7 percent and 12.5 respectively.
But in Missouri, about 28.4 percent of expectant mothers smoked, ranking it among the states with the highest maternal smoking rates, compared to 12.8 percent in New Jersey, ranking it among the lowest.
In New Jersey, a key reason for premature births is the number of twins, triplets and higher-order multiples being born as a result of in vitro fertilization procedures, Perl said. Twins are delivered on average, at about 35 weeks, triplets at 33 weeks, and quadruplets at 29 weeks, according to the American College of Obstetricians and Gynecologists.
Perl recommends fertility doctors follow American Society for Reproductive Medicine guidelines that call for implanting no more than two embryos at a time for women under 35, and no more than three for women with poorer chances of becoming pregnant.
About 540,000 babies are born prematurely in the United States each year, costing more than $26 billion in additional health care costs.
It's one of the reasons that the United States is ranked 30th in infant mortality, behind most other developed nations, according to a U.S. National Center for Health Statistics report issued earlier this month. Premature births have risen 36 percent since 1984, according to the report.
The March of Dimes has more about preventing premature births.
SOURCES: Jennifer Howse, Ph.D., president, March of Dimes, White Plains, N.Y.; Harold Perl, M.D., senior neonatologist, Hackensack University Medical Center, Hackensack, N.J.; March of Dimes 2009 Premature Birth Report Card