Tuesday, November 6, 2018

Rising preterm birth rate in the United States

March of Dimes just released its annual premature birth report cards, and the results aren’t good.

The data show that the preterm birth rate in the U.S. is on the rise for the third year in a row, at 9.93 percent in 2017. (Premature births are defined as occurring between 20 and 37 weeks of pregnancy, according to the American College of Obstetricians and Gynecologists.) Premature birth and its complications are the largest contributors to death in the first year of life in the U.S., and the leading cause of death of children under age 5 worldwide, March of Dimes points out.

“We’re very disturbed by the alarming trend,” Stacey D. Stewart, president of March of Dimes, tells Yahoo Lifestyle.

It’s hard to say what is behind this, but there are some theories, Jose Perez, MD, a neonatologist with Orlando Health Winnie Palmer Hospital for Women & Babies, tells Yahoo Lifestyle. A big one is maternal age, he says. “Moms are having babies at an older age than before,” he points out. “When moms are more mature, say in their 40s, the risk of delivering prematurely is higher.”

Fathers are also older than they’ve been in the past, and that plays a role. “New studies suggest that paternal age is linked to preterm delivery and increased complications,” Perez says.

At the same time, the rate of teen pregnancy is going down, which can also skew the numbers a little, he says.

Unequal access to health care is also a likely factor, women’s health expert Jennifer Wider, MD, tells Yahoo Lifestyle. “Certain racial and ethnic minorities and lower socioeconomic regions are at higher risk of preterm birth in the U.S.,” Wider says. “Lack of education about a healthy pregnancy and prenatal care, as well as a lack of understanding about risk factors and behavioral habits that can ensure a healthy outcome, is another possible factor.”

And finally, maternal conditions like hypertension and preeclampsia (a dangerous pregnancy complication also involving high blood pressure) can play a role, Perez says. “We don’t have a great handle on these conditions,” he says. “If the mom has hypertension or preeclampsia and we can’t control it, the likelihood is that she will deliver early.”

Currently, March of Dimes is taking steps to help lower the premature birth rate, including doing research in the underlying causes of premature birth, advocating for bills that would help protect pregnant women and their health, and launching programs across the country that would help ensure that women have access to medical and emotional support during pregnancy, Stewart says. “Stress and chronic stress can impact women’s health and the health of babies,” she says.

On an individual level, there are a few things women can do to lower the chances that they’ll have a premature birth. One is to get educated about “controllable risk factors, including obesity and tobacco use, so women can make healthy choices to ensure a healthy pregnancy,” Wider says.

Another is to make sure that they have good access to obstetric care and see their doctor regularly during the pregnancy, Perez says. Finally, having a healthy lifestyle before getting pregnant, and trying to bring any underlying conditions, such as hypertension or diabetes, under control before conceiving, are crucial, he says. “Those are just some factors that we can control a little bit,” he says.

Courtesy of Medpage

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