Preterm birth rate lower, but still far off target

Preterm births in the United States have decreased for 2 years in a row for the first time in 30 years but are still far above the national goal for 2010, says a March of Dimes report.

Of about 4.2 million babies born in 2008, 12.3% were delivered before 37 weeks’ gestation-down from 12.7% in 2007 and 12.8% in 2006-according to the most recent data from the Centers for Disease Control and Prevention. The gap between the 2008 rate and the 2010 Healthy People target of 7.6% earned the US a “D” on the March of Dimes annual preterm birth report card, issued November 17.

Preterm deliveries often result from elective inductions scheduled too early based on an inaccurate due date, notes Diane Ashton, MD, MPH, deputy medical director for the March of Dimes. She recommends that physicians determine the due date by ultrasound rather than the date of the woman’s last menstrual period.

Ashton also encourages doctors to follow American College of Obstetricians and Gynecologists (ACOG) guidelines for inducing delivery, which recommend against elective delivery before 39 weeks’ gestation unless continuing the pregnancy puts the mother or child at medical risk. The March of Dimes further urges physicians to educate women about ways to lower the risk of premature birth, including smoking cessation and regular prenatal care.

“There will always be pregnancies that need to be delivered early,” says Hal C. Lawrence III, MD, vice president of practice activities for ACOG. “Prematurity will never entirely go away, but we need to work to make the instance of premature birth as low as we safely can.”

Preterm birth is the leading cause of neonatal death in the US.