Premature Births Worsen US Infant Death Rate

Premature births, often due to poor care of low-income pregnant women, are the main reason the U.S. infant mortality rate is higher than in most European countries, a government report said Tuesday.

(AP Photo)

Premature births, often due to poor care of low-income pregnant women, are the main reason the U.S. infant mortality rate is higher than in most European countries, a government report said Tuesday.

About 1 in 8 U.S. births are premature. Early births are much less common most of Europe; for example, only 1 in 18 babies are premature in Ireland and Finland.

Poor access to prenatal care, maternal obesity and smoking, too-early cesarean sections and induced labor and fertility treatments are among the reasons for preterm births, experts said.

Premature babies born before 37 weeks tend to be more fragile and have under-developed lungs, said the lead author of the new report, Marian MacDorman of the U.S. Centers for Disease Control and Prevention.

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Premature births are the chief reason the U.S. ranks 30th in the world in infant mortality, with a rate more than twice as high as infant mortality rates in Sweden, Japan, Finland, Norway and the Czech Republic. For several years, the U.S. has ranked poorly among industrialized nations. MacDorman's report scrutinizes the reasons for that.

If U.S. infants were as mature as Sweden's are at birth, nearly 8,000 infant deaths could be avoided and the U.S. infant mortality rate would be about one-third lower than it is, according to a calculation by MacDorman and others at the CDC's National Center for Health Statistics.

Why so many more premature infants here? Experts offered several possible explanations:

—Fertility treatments and other forms of assisted reproduction probably play a role because they often lead to twins, triplets or other multiple births. Those children tend to be delivered early.

—The U.S. health care system doesn't guarantees prenatal care to pregnant women, particularly the uninsured, said Dr. Alan R. Fleischman, medical director for the March of Dimes.

—Maternal obesity and smoking have been linked to premature births and may also be a factor.