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No Comments [ Add Comment ]Utah gets "D" grade for premature birth rate
By JAMIE LAMPROSMURRAY -- The nation is in critical condition when it comes to preventing premature birth, and Utah is no exception.
As a whole, the nation received a "D" in the first premature birth report card issued by the March of Dimes. The report card includes data from 2005 to 2007, which is the latest available data. Several states received an "F," a handful received a "C" and Vermont received a "B." No state received an"A."
Despite the health care efforts, the rate of premature birth in Utah and the nation continues to increase, said Dr. Michael Varner, professor and vice chairman for research at the department of obstetrics and gynecology at the University of Utah Health Sciences Center, during a news conference Wednesday.
Most of the increase comes from late preterm birth, in which the baby is delivered between 36 and 38 weeks. A full term pregnancy is considered to be 40 weeks.
"There are multiple reasons behind premature births, although we clearly don't know them all," Varner said. "There is a 75 percent increase in the rate of multiple births, but there is also a disturbing increase in elective deliveries. We strongly support the recommendation of the American College of Obstetricians and Gynecologists that elective deliveries not be undertaken before 39 weeks."
The March of Dimes plans to issue the report every year. The organization compared actual preterm birth rates to the national Healthy People 2010 objective.
The "D" grade indicates how far Utah, with a preterm birth rate of 11.4 percent, is from that objective of 7.6 percent of all live births, said Stephen McDonald, marketing director for the March of Dimes. The national preterm birth rate is around 12.7 percent.
Amy L. Hansen, director of the March of Dimes Utah Chapter, said the report card illustrates the importance of ensuring every pregnant woman in Utah has access to health coverage and that even in tough economic times, vital care for women not be cut back.
"Protecting and expanding Medicaid eligibility for pregnant women will continue to be March of Dimes advocacy priorities," she said.
While survival rates are very good in preterm babies, Varner said, premature birth puts a child at increased risk for a number of problems, including respiratory problems, jaundice, poor feeding, sudden infant death syndrome and learning disabilities.
"We need to think about premature birth in more than just simple survival terms," Varner said. "There are times where we don't even find all of the problems until the child is in school."
Risk factors that can lead to premature birth include smoking, overweight or underweight mothers, C-sections and inductions that occur prior to 39 weeks gestation and previous premature deliveries, said Dr. Sean Esplin, maternal-fetal medicine specialist for Intermountain Medical Center.
Esplin said Intermountain Healthcare started an initiative in 2000 to review all C-sections and inductions to make sure they were meeting established protocols and professional guidelines.
"As a system, we moved from having 28 percent elective inductions before 39 weeks to about 3 percent and have sustained this for several years," he said. "We found that this was not only a clinical improvement but also resulted in savings for patients."
Preterm birth is the leading cause of death in the first month of life in the United States, according to the Institute of Medicine. Preterm birth rates have also increased more than 20 percent since 1990 and cost more than $26 billion annually.
The report card is calling for expanded federal support for research to find the cause of premature birth, which will lead to prevention and solutions. It also calls for policymakers to improve access to health coverage for women of childbearing age, to support smoking cessation programs as part of maternity care, and for businesses to create workplaces that support maternal and infant health, such as private areas to pump breast milk, access to flextime and information on healthy pregnancy and childbirth.
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