Preterm Birth

When a baby is born before 37 weeks of pregnancy, the birth is called a preterm birth and the baby is premature. In 2016, almost one of every 10 babies was born prematurely in the United States, a rate that has increased over the past year (NCHS 2018). Across the country, preterm birth rates were nearly 49 percent higher among black women and more than 18 percent higher among American Indian/Alaska Native women compared to white women (March of Dimes, 2017).

In Minnesota, prematurity is the second leading cause of infant death, 20.5% of infant deaths between 2012-2016. In 2016, 6,117 babies were born prematurely, 8.8% of all births. This is slight increase over the previous year (8.5%). Also disparities by race and ethnicity still exist. For instance, Native American (13.9%) and Black (8.9%) women have higher rates of giving birth prematurely than white women (8.6%).

Causes of prematurity

There are many reasons why women may have a preterm birth. Of the known risk factors for premature birth, some are able to be changed, some are not. Pregnant women may have one or more risk factors. Some of the more common reasons are listed below.

Medical Related Factors

• Personal or family history of premature birth
• Preterm premature rupture of membranes
• Preterm labor
• Short cervix
• Uterine infection
• Sexually transmitted infections
• Maternal health problems such as high blood pressure, diabetes
• Being underweight or overweight before pregnancy or not gaining enough weight during pregnancy
• Carrying twins or multiples

Lifestyle/Personal Factors

• Smoking (including second hand smoke)
• Drinking alcohol
• Using street drugs or misuse of prescription drugs
• Intimate Partner violence
• Stress
• Close child spacing (less than 18 months between pregnancies)
• Seeking care late in the pregnancy
• Early elective delivery
• Poverty
• Some racial groups such as African Americans and American Indians
• Maternal age - younger women under 17 and older women over 35

Environmental Factors

• Exposure to pollutants - chemicals in the air, water, or in personal care products such as phthalates, Bisphenol-A (BPA), flame retardants, air pollution, lead.

Costs of prematurity

Physical

Premature babies tend to suffer from lifelong health problems. For example, some may develop illnesses that affect their breathing, they may have feeding and digestive problems, cerebral palsy, intellectual and/or developmental delays that lead to challenges in school and much more.

Financial

Premature birth can cost families a great amount of money. Premature birth leads to longer hospital stays and the cost of care in a neonatal intensive care unit is very expensive. Medical insurance helps, but many parents struggle to pay out-of-pocket costs or services that insurance does not cover. The average medical cost for the birth of a healthy baby is $4,389; for a premature baby it's $54,194. For the 6,054 babies born prematurely in Minnesota in 2014, that represents an extra $302 million in costs to families and insurers. After the birth and initial hospitalization there can be longer term costs for things like more frequent medical visits, adaptive equipment, and special education.

Personal

Premature birth can disrupt parental and family relationships. Recovery from birth can be complicated by daily commutes to the hospital to visit their infant, stress, lack of sleep, feelings of guilt or blame, anger or fear, siblings who may feel neglected, the need for child care for their children at home, loss of the dream of a perfect child, family, and relationships.