March of Dimes Premature Birth Report Card Gives US Poor Grade

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Each year, the March of Dimes, the nation’s leading organization for pregnancy and baby health, tracks premature birth rates and gives a report that ranks each state and the nation overall on the number of babies born before 37 weeks of gestation.

The 2009 March of Dimes Premature Birth Report Card grades states based on a score called “HP 2010” in reference to the Healthy People 2010 program which sets health goals for the nation to accomplish. The rate is calculated from the formula (2005 preterm birth rate – HP 2010 objective)/standard deviation of 2005 preterm birth rate. A rate less than or equal to 7.6% gets a grade of “A”.

No state received a grade of A, and only Vermont received a grade of B which indicates a preterm birth rate of greater than 7.6%, but less than 9.4%. New Hampshire also had a rate less than 10%, but at 9.4 it ranked a high “C” grade.

While the nation overall was given a grade of “D”, seven states improved their performance over 2008 by a full letter grade, including Idaho, Utah, Wisconsin, Massachusetts, Missouri, Arizona, and Indiana.

18 states and the territory Puerto Rico received the lowest grade of “F” with over 13.2% preterm births. Many of these states are located in the SouthEast, inlcuding Texas, North Carolina, Georgia, Florida, South Carolina, Louisiana, Alabama, and Mississippi.

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Babies born before 37 weeks of gestation are at risk for lifelong problems, including cerebral palsy, breathing and digestive problems, and developmental disabilities. Premature birth can also lead to infant mortality. A recent report by the US National Center for Health Statistics has found that the United States ranks 30th among all nations in infant mortality, behind many other developed countries.

The March of Dimes has identified three contributing factors for the low scores: uninsured women with inadquate prenatal care, maternal smoking, and elective inductions or cesarean sections prior to 37 weeks – called late preterm births. Other risk factors for preterm births include twins and other multiples that are typically delivered early, problems with the uterus or cervix, certain infections during pregnancy, and chronic health conditions in the mother, such as diabetes and high blood pressure.

The report did reveal some positive trends. 33 states and the District of Columbia have reduced the percentage of women of childbearing age who smoke, a major risk factor for premature births. 21 states have reduced the percentage of women who are uninsured and 27 states lowered the rate of late preterm births.

To lower rates of preterm births, states can institute a wide range of education and interventional programs, including smoking cessation efforts, consistent care before and during pregnancy, identification of women appropriate for progesterone supplements (to reduce the rate of preterm birth in high-risk women), and improved use of professional guidelines on fertility treatment and early C-sections and induced births, according to March of Dimes recommendations.

About 543,000 babies are born prematurely in the United States each year, an increase of 36% since 1984, costing more than $26 billion in health care costs.

November is Prematurity Awareness Month

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