Why Are Premature Birth Rates On The Rise Again? : Shots

The rate of premature birth in the United States for a third year in a row, according to the first premature birth report of the March of Dimes, a nonprofit organization that works to improve maternal and infant health. This comes after nearly a decade of decline from 2007 to 2015.

In 2017, the first birth rate was 9.93 percent of births, up slightly from 2016, when it was 9.85 percent. The report card from the latest Centers for Disease Control and Prevention data.

Becky Russell, the senior director of research and evaluation at the March of Dimes, but it means about 3,000 more babies who were born prematurely. She says it's a worrying trend line. "If you look at the increases since 2014, cumulatively we're talking about 27,000 babies," she says.

One bright spot in the report has been one of the three states and Puerto Rico did not show their first birth rates. The states with the highest premature birth rates are mostly in the South and the lower Midwest. The highest rate in Mississippi was 13.6 percent and the next in Louisiana was 12.7 percent. Vermont had the lowest rate at 7.5 percent.

Prematurity – or birth before 37 weeks of pregnancy – is a leading contributor to infant death in the United States. The survival rate of premature babies has gone up in recent decades. But, babies born prematurely remain at a higher risk of a range of developmental problems later in life, like cerebral palsy, vision and hearing problems, and more developmental delays, according to the CDC.

"It's not certain what's driving the rise in the premature birth rate, social and economic factors play a big role," says Russell. For example, "maternal care, maternal care, and high poverty rates," a mother's risk of delivering prematurely, she says.

A mother's race or ethnicity also determines her risk of having a preterm baby. African American women have the highest risk of all racial and ethnic groups in the country with a 13.4 percent rate, based on data aggregated from 2014-2016. White women had a rate of 8.9. Black women have a 49 percent higher rate of race than other races and ethnicities.

Over the last few years, racial disparities in premature birth have gotten worse, according to the March of Dimes report.

However, it's racism and structural discrimination, says Rachel Hardeman, a public health researcher at the University of Minnesota who studies the effect of racism on various health outcomes. African American Mothers, which also has a higher risk of infant death.

Structural discrimination, says Hardeman, can determine where someone lives, their education and income levels, amenities they have access to, including health care facilities. A lower education and employment level is better known for precaturity and precatalyte.

"Structural determinants are misleading," says Hardeman.

A 2013 Harvard study that showed that black women in Jim Crow states had a higher rate of infant mortality than in other states.

The March of Dimes brings some hope to the country. Iowa, Rhode Island, Wyoming and Puerto Rico reduced their preterm birth rates in 2017.

Rhode Island has reduced its preterm birth rate steadily since 2007, when the rate was 10.8 percent. In 2017, it dropped to 8.3 percent.

In 2007, Dr. Ailis Clyne, the medical director at the Division of Community Health and Equity at the Rhode Island Department of Health, said.

The task force has been working on expanding coverage for pregnant and postpartum women. "We really wanted to make sure we had better health insurance coverage during pregnancy, as well as postpartum." says Clyne.

Clyne explains that the postpartum period often leads to the next pregnancy and is crucial for women.

If they have access to a health care provider during this time, it can make it easier for women to get help in their diet, or improve their nutrition, or quit smoking. It also helps ensure they have a minimum birth rate of 18 months between two pregnancies, which also helps cut risks.

Primary health care providers in Rhode Island use something called "pregnancy intention screening," says Clyne. The screening is for all women of reproductive age, and asks them one question: 'Would you like to become pregnant in the next year?'

This ensures that they are getting regular help and help in getting things done that can influence their chances for going into labor prematurely. "Fortunately, we do not have coverage during pregnancy."

"Says Russell," and that's what it's all about. " "If we do not have a system that allows us to understand, we run the risk of seeing larger disparities, instead of a gap," she says.