Premature Births on the Rise

Too many babies are being born too soon, say doctors and health officials who report a jump of 27 percent in premature births over the last 20 years.

"The problem is huge. One in eight babies is born prematurely, and these babies are at increased risk for neurological, hearing, behavioral and IQ problems," says Dr. Nancy S. Green, a New York City pediatrician and medical director of the March of Dimes. "But prematurity is not a high-priority health issue like other issues in maternal health."

The March of Dimes hopes to change that, today announcing a $75 million, five-year national program to increase awareness of premature births and decrease the number of babies born before 37 weeks of gestation.

The rate of premature births jumped from 9.4 percent of live births in 1981 to 11.9 percent in 2001, Green says, and the March of Dimes would like to see the rate lowered to no more than 10.1 percent of live births.

"This would mean 70,000 to 80,000 fewer preterm babies annually," she says.

Some of the increase in premature births can be blamed on an increase in known risk factors for premature births, including a rise in the number of older women giving birth and the explosion of obesity in the country, Green says.

Older women, for instance, are more likely to have twins, half of whom are born prematurely, Green says, "and reproductive technology has also contributed to the births of more twins and triplets. Almost 90 percent of triplets are born prematurely."

However, about half of premature births have no known cause, and Green says further research is needed to understand those causes.

The public is largely misinformed about what causes premature delivery, two March of Dimes surveys found. One survey of 600 pregnant women and a second of 2,000 men and women found that two-thirds of both groups felt that premature births were due to a mother not taking care of herself -- smoking, abusing drugs or not getting prenatal care.

That's because doctors thought so, too, says Dr. Ian Holzman, chief of newborn medicine at New York City's Mount Sinai School of Medicine.

"It has been medicine's perception that if we can just get everybody into prenatal care, we'll stamp out prematurity, but it isn't that simple," he says. "Premature deliveries continue to be a major health issue, and what is disturbing is that the rates haven't come down even though other areas of health care have improved. This campaign is important."

The results of the two March of Dimes surveys appear, respectively, in the January Contemporary OB/GYN and the February American Journal of Preventive Medicine.

The March of Dimes campaign, Green says, will also work to alert parents to how seriously premature births can affect children's long-term development. Only one-third of the respondents of both surveys reported that prematurity was a very serious problem, and many are unaware the condition can affect a child's health when they are older.

"Among babies who are premature and have some early breathing problems, there is a definite increase in the amount of asthma and more severe problems with colds," Holzman says.

Premature births are births that take place before 37 weeks, or about nine months, of gestation. Most premature births take place between 32 and 37 weeks, but about 2 percent of premature births take place between 28 and 32 weeks, at six-and-a-half months, Green says.

While the health risks of the early births are considerable, including those of infection from being hospitalized, being able to prolong gestation for even a week during this time can considerably improve odds for the baby, Green says.

"Once labor starts it can be slowed, stopped or, more often, delayed if a woman gets medication, and a few days can make a big difference in the outcome for the baby," she says.

More information

A story about how one child has coped with a premature birth can be found at the March of Dimes. For some of the risks of preterm delivery go to the National Institutes of Health.

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