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Prematurity at birth: trends, racial disparities, and epidemiology
Greg R Alexander1, Martha Slay
1Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama 35294-0022, USA.
Insights
While infant mortality declines, preterm birth rates rise due to improved survival of high-risk infants. Effective prevention remains limited, necessitating early detection and support for preterm infants.
Area of Science:
- Neonatal Health
- Public Health Trends
- Perinatal Medicine
Background:
- Infant mortality rates have decreased in the U.S.
- However, rates of low birth weight and preterm birth have significantly increased.
- This rise may be partly attributed to interventions aimed at improving the survival of high-risk infants.
Purpose of the Study:
- To examine the complex trends in infant mortality, low birth weight, and preterm birth rates in the U.S.
- To understand the role of medical advancements and prenatal care in these trends.
- To highlight the need for support services for surviving preterm infants.
Main Methods:
- Analysis of national vital statistics and healthcare data.
- Review of medical literature on prematurity risk factors and interventions.
- Examination of racial disparities in pregnancy outcomes.
Main Results:
- Declining infant mortality contrasts with increasing low birth weight and preterm birth rates.
- Medical advancements and improved prenatal care may contribute to rising prematurity while improving survival.
- Racial disparities in pregnancy outcomes have widened.
Conclusions:
- Effective prevention strategies for prematurity are limited.
- The number of surviving preterm infants is expected to grow.
- Early detection, treatment of developmental issues, and robust support services are crucial for high-risk preterm infants and their families.
Abstract:
While infant mortality rates have continued to decline in the U.S., low birth weight and preterm rates have dramatically increased. Although the combination of factors that underlies these trends has not been fully described, there is growing concern that an appreciable part of the rise in prematurity rates stems from efforts taken to improve the survival of these high-risk infants. While advancements in medical technology and practice, augmented by improvements in prenatal care use, may have adversely effected prematurity rates and played a role in broadening racial disparities in pregnancy outcomes, they have positively impacted infant survival. Although many risk factors for prematurity have been identified, there are presently few areas for effective prevention. Accordingly, there is little encouragement for a downturn in prematurity rates in the near future. The prospect of continuing growth in the annual number of surviving preterm infants in the U.S. highlights the need for early detection and treatment of developmental problems for these high-risk survivors, and emphasizes the importance of assuring that needed support services are available to these children and their families.