Many Preterm Births are Preventable; U.S. Lags Many Other Developed Countries
Fifteen million babies. That’s how many of the 135 million worldwide births were premature in 2010, according to a new multi-agency, multi-national report from the United Nations. Worse, 1.1 million of these infants died soon after birth, and millions more suffer from permanent physical and mental disabilities.
Born Too Soon: The Global Action Report on Preterm Birth is the first synthesis of global, regional, and national estimates of preterm births. It is part of the U.N.’s “Every Woman, Every Child” effort to put a global spotlight on one of the big challenges to improve women and children’s health. The report explains what is known about preterm birth, its causes, and the kinds of care that are needed. Preterm is considered any baby born before 37 weeks.
The United States is ranked well below almost every other developed country in preventable premature births – at 131 out of 184. About one in nine babies, 517,400, were born prematurely in 2010. That rate is on par with developing countries like Somalia. It seems at odds with our highly touted health care system.
However, Jennifer Howse, M.D., President of March of Dimes, one of the lead organizations that contributed to this report, said the high preterm birth rate in the U.S. is linked to the older age of women having their first child, use of fertility drugs and resultant multiple pregnancies, as well as many women opting for medically induced and Caesarean deliveries (C-sections) before full term (39 weeks).
In addition to the human costs, preterm birth also has high economic costs: more than $26 billion annually, according to the Institute of Medicine.
“This report offers conclusive evidence that the United States rate of preterm birth has been far too high for far too long,” said Dr. Howse. “While our country excels in helping preemies survive, we have failed to do enough to prevent preterm births and help more mothers carry their babies full-term.”
Brazil was the only other developed nation in addition to the U.S. among the 11 countries with preterm birthrates above 15 percent. The other nine were in sub-Saharan Africa, where poverty is the biggest contributor to this problem. Inadequate prenatal care, infections such as malaria and HIV, high blood pressure, diabetes, mothers that are obese or underweight and substance abuse, including smoking, are issues than can be resolved for relatively low cost, the experts said. Addressing preterm birth is now an urgent global priority for the United Nations, in reducing child deaths by 2015 and beyond.
These statistics are heart wrenching, especially when some 75 percent of those preterm infant deaths can be averted if a few proven and cost-effective treatments and preventive measures were more accessible. That was the consensus of more than 100 experts who contributed to the report, representing 40 UN agencies, universities, and organizations.
Better access to medicines, educating more women about having healthy, full-term pregnancies, and improving respiratory care and infection control for premature infants have all helped a number of nations cut the rate of neonatal deaths dramatically.
Although the United States has some of the best high-tech care in the world for preemies, the best approach is to prevent children from being born too soon whenever possible. The report advises taking effective measures now, such as screening women for known medical conditions that could put them at risk during pregnancy, assuring good nutrition before and during pregnancy, and making sure that all women have access to good preconception and prenatal health care and receive the recommended number of visits during pregnancy.
Making sure that all women have access to that care, regardless of insurance status or income in the United States would be a great start. We can do better. We have to – those babies are counting on us.
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Liz Seegert is a freelance journalist in New York City who writes and blogs on health, social policy, and other issues impacting human welfare. She is also a Senior Fellow at the Center for Health, Media & Policy at Hunter College. You can follow Liz on Twitter (@lseegert).
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