Preterm Birth: Two Startling Trends, One Call to Action

Area of Science:

• Public Health
• Maternal and Child Health
• Demography

Background:

• The United States has experienced a continuous rise in preterm births (births at <37 weeks' gestation) since 2014.
• This increase is occurring alongside a more than doubling of pregnancy-related mortality rates over the past 25 years.
• Significant racial and ethnic disparities exist, with women of color facing higher risks of preterm birth and maternal mortality.

Purpose of the Study:

• To highlight the concerning trends in preterm births and pregnancy-related deaths in the US.
• To underscore the inequitable impact of these outcomes on racial and ethnic minority populations.
• To advocate for a new, systems-level approach to address these public health crises.

Main Methods:

• Analysis of data released by the Centers for Disease Control and Prevention (CDC) for 2018.
• Review of the March of Dimes annual report card assessing national outcomes.
• Examination of trends in preterm birth rates and pregnancy-related mortality over time.

Main Results:

• A fourth consecutive annual increase in preterm births was reported for 2018.
• The national preterm birth outcome received a "C" grade from March of Dimes.
• Pregnancy-related deaths have more than doubled in the US over 25 years, with Black, American Indian, and Alaska Native women at 2-3 times higher risk than white women.

Conclusions:

• The persistent rise in preterm births and maternal mortality necessitates a reevaluation of current strategies.
• Addressing the crisis requires acknowledging and rectifying the disproportionate burden on minority women.
• Population-based, systems-level interventions are crucial for improving maternal and infant health outcomes.