US fails again in report on preterm birth, a leading cause of infant mortality
EDUARDO CUEVAS, USA TODAY
November 16, 2023
The U.S. has landed another poor grade when it comes to preterm births, with festering disparities in outcomes for Black and Native women that are life-threatening, according to a new annual report.
Preterm birth, when babies are born before 37 weeks gestation, is among the leading causes of infant death in the U.S., according to the March of Dimes. Outcomes across the country improved only slightly this year. In 2021, just over one in 10 babies were born preterm, and that was true again in 2022. Because of this, the March of Dimes, a decades-old health nonprofit for mothers and babies, gave the U.S. a D+ grade, the same as the previous year, in its “State of Maternal and Infant Health for American Families” report card published Thursday.
Ashley Stoneburner, a data scientist with March of Dimes, who was a report author, told USA TODAY it's hard to make sense of why mothers and babies are so at risk.
“We live in one of the wealthiest nations, and our health of moms and families is getting worse year after year,” Stoneburner said.
'Preterm birth is just the tip of the iceberg'
The report comes amid spikes in national infant and maternal mortality rates that have a disparate impact on communities, across race, class and geographical boundaries.
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“All these indicators are connected,” Stoneburner said. “And preterm birth is just the tip of the iceberg.”
Factors that exacerbate preterm birth include pre-pregnancy hypertension and diabetes, as well as smoking, unhealthy weight and a previous preterm birth, the report said.
The report showed gaps in women's and infants’ health along these faultlines. Black and Native women were 54% more likely to have preterm deliveries than white women. Babies born to Black and Indigenous mothers had death rates 2.3 times higher than those born to white and Hispanic mothers. The infant mortality rate also increased overall, as data from the National Center for Health Statistics recently showed an uptick for the first time in two decades. Maternal deaths doubled from 2018 to 2021, with greater increases among Black and Native women.
Amid the slight drop in preterm births, 14 states saw increases in preterm births. Preterm births have steadily risen in the last decade, according to the March of Dimes, which has published its annual report since 2008.
The March of Dimes’ index showed mothers giving birth in states in the Southeast, Appalachia and Midwest had higher levels of vulnerability and poorer outcomes. In its ratings, the March of Dimes gave eight states, mostly in the South, along with West Virginia and the territory of Puerto Rico, an F grade. No states earned an A, although just eight states – in New England, the West Coast and Idaho – earned B grades.
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The report cited 100 cities with the most live births, one-third of which earned F grades. These included Birmingham, Alabama, which had the nation’s highest birth rate, and Rochester, New York, and El Paso, Texas.
“The fact is, we are not prioritizing the health of moms and babies in this country,” Dr. Elizabeth Cherot, the president and CEO of March of Dimes, said in a statement.
The report called for an array of policy actions to improve health outcomes, such as increased federal funding to perinatal efforts to improve health outcomes across states, and efforts to extend Medicaid maternity coverage to one year after childbirth. The coverage currently ends 60 days after a pregnant person delivers a baby.
These problems are not new, but improving maternal and infant care is imperative, the report says. As the American College of Obstetricians and Gynecologists recently put it, "The maternal access crisis in the United States is nothing short of catastrophic."
Eduardo Cuevas covers health and breaking news for USA TODAY. He can be reached at EMCuevas1@usatoday.com.
This article originally appeared on USA TODAY: On preterm labor, U.S. gets failing grade (again) in new report
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