KIDS COUNT Data Center

Too Many Babies Born Before Their Time: The Growing Problem of Preterm Births Number Five, September 2007 Printer-friendly (PDF) version

Data Highlights | Background on Preterm Births | How Your State Ranks | What You Can Do | Sources | About the Data Snapshot Series

In 2004, one in eight babies in the United States was born preterm, or before the 37th week of pregnancy. This represents more than half a million infants—the highest number ever recorded. The share of babies born preterm, also referred to as premature, has grown steadily from 1990 to 2004, from 10.6 percent to 12.5 percent. Preliminary national data show that this trend continues with 12.7 percent of babies born preterm in 2005.

Advances in medical care have improved the survival rate for preterm infants, but infants who survive face a greater risk than full-term babies for a host of serious health and developmental problems. While researchers are investigating the specific causes of preterm births and how to prevent them, the economic and emotional costs to families and communities continue to grow. According to a recent report from the National Academy of Sciences, premature births cost the nation $26 billion a year for expenses like neonatal intensive care units.

A healthy start in life is critical. Many babies who start off life with health problems never fully catch up with their peers, leaving them at a developmental disadvantage as they get older. Through research and grant making, the Casey Foundation is supporting efforts to identify interventions that reduce preterm births and help ensure that all children enter school ready to learn and succeed.

Data Highlights

• The share of preterm births varies widely across the nation’s cities and states. Among the states, the rate ranges from a low of 8.3 percent in Vermont to a high of 17.9 percent in Mississippi. Among large U.S. cities, six shared a rate of 9 to 10 percent— the lowest in the country: Oakland, Sacramento, San Francisco, and San Jose, California; Portland, Oregon; and Seattle, Washington. New Orleans, Louisiana, had the highest rate of all large cities at 19.7 percent.
  
  
• The percent of preterm births increased in every state between 1990 and 2004, excluding Georgia where the rate was the same in both years. For some states, the increase was small, but in Kentucky, Massachusetts, North Dakota, and West Virginia, the share of preterm births increased by 4 percentage points over that time period.
  
  
• Preterm birth rates vary substantially by race and ethnicity. While the rates of non- Hispanic white, Asian and Hispanic preterm births fall between 10.5 and 12 percent, the rate for non-Hispanic blacks is at least 50 percent higher at 17.9 percent. The rate for American Indian or Alaska Native babies, at 13.7 percent is also higher than most other groups.

Figure 2 — Percent of births that were preterm by race and Hispanic origin: 2004

Source: CDC, National Vital Statistics Reports, Vol. 55, No. 11, Births: Preliminary Data for 2005

• For non-Hispanic whites, and to a lesser extent for Hispanics, the share of preterm births have increased steadily for more than a decade. The rate of preterm births increased by 35 percent for non-Hispanic whites and 9 percent for Hispanics since 1990. For non- Hispanic blacks, the percent of preterm births fell during the 1990s, but increased slightly since 2000. The rate in 2004 (17.9 percent) was one percentage point lower than in 1990 (18.9 percent). National trends in birth outcomes for the largest racial and ethnic categories can be found in The Right Start For America’s Newborns available on the Kids Count Online Data System www.kidscount.org/sld/ 9indicators_by_race.pdf.

Background on Preterm Births

According to the National Institute of Child Health and Human Development (NICHD), babies born preterm are more likely to suffer from numerous problems, including:

• Low birthweight;
• Breathing problems because of underdeveloped lungs;
• Underdeveloped organs or organ systems;
• Greater risk for life-threatening infections;
• Greater risk for a serious lung condition, known as respiratory distress syndrome;
• Greater risk for cerebral palsy; and
• Greater risk for learning and developmental disabilities.

The increase in the share of preterm births is due, in part, to a rise in multiple births in the United States overall. However, it is important to note that even for single births, the share of births that are preterm has increased since 1990. In addition, the increased likelihood of African-American women, as well as women with low-income levels, having a preterm birth persists.

The overall health, including mental health, of a woman prior to becoming pregnant is an important determinant of birth outcomes. Improvements in health care access and quality for women at higher risk to have a preterm birth can help to increase the likelihood of their babies being born healthy.

A recent study by the Casey Foundation found that a significant number of women having preterm births have symptoms such as hypertension or diabetes. Consequently, interventions that can reduce hypertension and diabetes among women in their childbearing years, including anti-obesity campaigns, may have a positive impact on preterm births. The Casey Foundation is currently funding culturally specific anti-obesity interventions in four sites: Boston, Massachusetts; Denver, Colorado; Richmond, Virginia; and Washington, DC.

How Your State Ranks

The table below shows the 50 states ranked by the percent of babies born preterm in 2004.

Figure 3 — States ranked by percent of babies born preterm: 2004

Source: KIDS COUNT State Level Data Online www.kidscount.org/sld

Definition of Preterm Births: Babies born with a gestational age of less than 37 completed weeks.

The Casey Foundation tracks eight birth outcomes, including percent of babies born preterm, in its report, The Right Start for America’s Newborns. Data are available for all states as well as 55 large cities from 1990 to 2004.

• Preterm births by state, 2004
• Preterm births by city, 2004

KIDS COUNT state grantees have produced state reports on the unique issues facing babies born preterm. Visit the KIDS COUNT issues library.

What You Can Do

Policies and programs across the country are emerging or expanding to counter the growing number of children born prematurely. The following are resources to support mothers and infants across the country:

• The March of Dimes Prematurity Campaign
  A research, education, and awareness campaign to help families have healthier babies. The Campaign funds research to find the causes of premature birth and ways to prevent it. At the same time, the Campaign focuses on what can be done today to address the problem. This includes risk reduction and education for pregnant women and women of childbearing age, including efforts to reduce disparities, and supportive programs for parents with a baby in intensive care.
  
  
• The March of Dimes Peristats
  Developed by the March of Dimes Perinatal Data Center, the PeriStats Web site provides free access to US, state, county, and city maternal & infant health data including “Prematurity Profiles” for many cities and counties nationwide.
  
  
• National Library of Medicine and National Institutes of Health - Mediline Plus: Premature Babies
  This website provides a wide range of information for researchers, policy makers, medical professionals and parents of premature babies including the latest research and best practices to support parents their babies.
  
  
• National Academy of Sciences, 2006, Preterm Birth: Causes, Consequences, and Prevention, Institute of Medicine, National Academy Press, Washington, DC.

Sources

Data for this report was compiled by Child Trend through analysis of 1990-2004 Natality Data Set CD Series 21, numbers 2-9, 11-12, 14-16 (SETS versions), and 16H and 17Ha (ASCII version), National Center for Health Statistics.

Kazandjian, Vahe A., C. Patrick Chaulk, Sam Ogunbo, and Karol Wicker, 2007, “Does Cesarean Section Delivery Always Cost More Than Vaginal Delivery?” Journal of Evaluation in Clinical Practice, No. 13.

Martin, Joyce A., Brady E. Hamilton, Paul D Sutton, Stephanie J. Ventura, Fay Menacker, and Sharon Kirmeyer, 2006, “Births: Final Data for 2004,” National Vital Statistics Reports, Vol. 55, No. 1, September.

National Academy of Sciences, 2006, Preterm Birth: Causes, Consequences, and Prevention, Institute of Medicine, National Academy Press, Washington DC.

National Institute of Child Health and Human Development, “Preterm Labor and Birth”, Updated 1/15/2007. www.nichd.nih.gov/health/topics/premature_labor_and_birth.cfm.

Schumacher, Hamm, et. al. Starting Off Right: Promoting Child Development from Birth in State Early Care and Education Initiatives, Center for Law and Social Policy, July 2006 www.clasp.org/ChildCareAndEarlyEducation/StartingOffRight/5008.

About the KIDS COUNT Data Snapshot Series:

The Data Snapshot series highlights specific indicators of child well-being contained in the KIDS COUNT State-Level Data Online system.

KIDS COUNT, a project of the Annie E. Casey Foundation, is a national and state-by-state effort to track the status of children in the United States.

KIDS COUNT exemplifies the Foundation’s commitment to using the best available data to measure the well-being of children and to enrich local, state, and national discussions concerning ways to secure better futures for all children.