Understanding the problem of premature birth

Premature births are on the rise in the U.S., as my colleague Laura Blue reported recently, and despite all of the health care dollars being spent to usher preemies safely into the world—some $26 billion annually—too often they number among the 30,000 babies under a year old who die every year in this country. It's a grim figure, and one that places the U.S. squarely behind nearly every other developed nation in the world for this basic health measure. And in a white paper released this week by the March of Dimes—a non-profit organization dedicated to improving infant mortality rates and combating premature births—researchers paint a stark picture of the problem of premature births, not only in the U.S., but around the globe.

The research, which will be presented at the International Conference on Birth Defects and Disabilities in the Developing World this month in New Delhi, finds that around the world nearly 13 million babies are born prematurely, or earlier than 37 weeks into the mother's pregnancy. Premature birth increases the risk for complications including physical ailments, learning disabilities and other neurological problems, and often, death. According to the research, 28% of newborn deaths are due to premature birth.

At present it's difficult to get a firm grasp of the problem in all parts of the world, due to the widely varying nature of data collection, and even discrepancies in the very definition of preterm birth. Yet, with the data available now, it is clear that the problem is not evenly distributed around the globe. Worldwide, the average preterm birth rate is 9.6% of all live births, but in Africa, the rate is 11.9%—representing more than 4 million babies every year. In the U.S., premature births have increased by 36% in the last quarter century, and the current premature birth rate in the U.S. and Canada is 10.9%—far higher than the rate of 6.2% in Europe, or 6.4% in Australia and New Zealand, for example.

Researchers say the sharp incline in American premature births is likely the result of the growing use of fertility treatments and resulting increase in twin, triplet and other multiple births, the increasing prevalence of women having children after age 35, and other factors, yet more research needs to be done to fully understand what drives the prevalence of premature birth elsewhere in the world. (Currently, 85% of all premature births take place in Africa and Asia.)

While more study is needed, authors of the March of Dimes White Paper say there are some factors which pregnant women can address that can reduce their risk for giving birth prematurely—including maintaining healthy nutrition and body weight, abstaining from alcohol and tobacco and when avoidable, not opting for early, induced childbirth or an elective Cesarean section delivery.