U.S. Gets 'C' Grade in Premature Births

PHOTO: Premature baby Ethan Pugh, son of pediatrician Dr. Bonnie Pugh, was born at 24 weeks and 6 days. He required a ventilator to help him breathe for the first month of his life.
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The March of Dimes has once again given the United States an unenviable "C" rating with regard to preterm birth rates.

Statistics suggest that the country has actually been doing a better job in recent years, cutting its rate of premature births -- babies born before 37 weeks of pregnancy -- from a 12.8 percent peak in 2006 to 11.7 percent in 2011, the most recent year for which figures are available.

Despite these improvements, however, the U.S. still failed to meet the March of Dimes' pre-term birth rate goal of 9.6 percent -- earning the country the shaky grade on the organization's 2012 Premature Birth Report Card.

The March of Dimes, a leading nonprofit organization for pregnancy and baby health, released its report card in the midst of November's Prematurity Month, and just before World Prematurity Day on November 17.

The March of Dimes' president, Dr. Jennifer Howse, applauded the declining number of preemies, saying, "These results demonstrate that many premature births can be prevented with the right policies and bold leadership."

While only four states met the March of Dimes' goal -- Vermont, Oregon, New Hampshire, and Maine -- 45 states saw improvement in their preterm birth rates between 2009 and 2011.

Dr. F. Sessions Cole, Chief Medical Officer at St. Louis Children's Hospital, said that for states to reach their goals, the focus of research on preterm births needs to shift.

"From a public policy perspective, the U.S. needs to make prevention of prematurity a national goal that is supported by research and clinical funding," he said. "Currently, the U.S. is spending too much money on technology to treat the consequences of prematurity and not enough on understanding strategies to prevent prematurity."

Preterm birth costs the country an estimated $26 billion each year, according to the CDC.

While the exact causes of preterm birth are unclear, there are several known risk factors. According to the March of Dimes website, women who smoke, drink, or use drugs, have chronic health problems, high blood pressure, or certain infections are more at risk for preterm deliveries. Mothers who are underweight or overweight, pregnant with multiples or who have already had a premature infant are also at risk for giving birth prematurely.

According to the March of Dimes and the World Health Organization, an estimated 15 million babies are born prematurely worldwide, and one million of those infants die because of it. In a global report issued by the March of Dimes and several partners in May of this year, the U.S. ranked poorly at 131 out of 184, far behind counties such as a France, China, and the U.K.

In order to put a face to the numbers of premature birth, Facebook, which has partnered with the March of Dimes, said it would have an interactive world map on World Prematurity Day showing heart-wrenching baby stories.

Dr. M. Bonnie Pugh, a pediatrician and mother, said she knows firsthand the tumultuous feeling of having a baby too early.

"It was a very scary experience having Ethan born 15 weeks early. I kept saying over and over in my head that it was too soon." said Pugh, whose son, Ethan, weighed only 1 pound and 11 ounces when he was born. Ethan needed a blood transfusion almost immediately after birth and was on and off a ventilator for about the first month of his life.

When Dr. Pugh went into pre-term labor, a neonatal intensive care unit (NICU) team came to visit her to talk about her son's prognosis. "There's a fifty percent chance he's going to live, and a fifty percent chance that he won't," they said, according to Pugh.

Five and a half years later, Ethan attended kindergarten for the first time. Dr. Pugh credits the NICU staff and the research funded by the March of Dimes, an organization she joined while Ethan was still in the NICU.

Too Many Babies Born Too Soon

Most recently, the March of Dimes has been targeting health care providers in its campaign "Healthy Babies are Worth the Wait," in which it urges providers and patients not to schedule a delivery until after at least 39 completed weeks of pregnancy unless there is a medical reason.

According to the March of Dimes website, infants born after 39 weeks have more time for key organs to grow, such as the brain, lungs, and liver. They are also less like to have problems with their eyesight and hearing after birth, and more likely to have a good weight which will help keep their bodies warm.

Cole said he has hopes that the push for ending non-essential pre-term deliveries will help with better outcome for babies.

"Hopefully, the decline in non-medically indicated, elective late preterm births will continue to reduce the nation's overall prematurity rate," he said. "This decline will improve outcomes of both mothers and babies by reducing maternal delivery-associated morbidities, reducing need for neonatal intensive care for late preterm infants, and improving outcomes for babies."

Healthier babies would translate into healthcare savings, according to Howse.

"All this improvement means not just healthier babies, but also a potential savings of roughly $3 billion in health care and economic costs to society," she said.

For Pugh, the cost of Ethan's 96 day NICU stay was well worth it.

"He's doing really well in school," she said, adding that while Ethan has some mild gross motor delays that may affect activities like running, jumping, and balancing, he is catching up pretty well.

"Prematurity can happen to anybody," she said. "Having lived through that experience made me want to give back to other moms who have gone through premature birth."

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