November is Prematurity Awareness Month. In recognition of this important issue, this “From Science to Public Policy” article is devoted to the developmental issues associated with prematurity, the policy implications, and opportunities for advocacy action.
Introduction
Preterm birth, defined as a birth occurring before 37 weeks gestation, places infants at high risk of long-term hospitalization, developmental challenges, and infant death. The causes of preterm birth are not well understood. Preterm deliveries have been attributed to a variety of factors ranging from poor prenatal health care, poor nutrition, maternal health, smoking, weaknesses in the reproductive tract, viruses and infections, stress, prior history of preterm birth, multiple gestation, and many other potential factors that have no t been identified. Whatever the reason, preterm delivery is the most likely cause of death unrelated to birth defects in infants under one year of age. Preterm birth imposes a huge medical cost on society, and emotional burdens on the family. The Healthy People 2010 goals target preterm birth, with a goal to reduce preterm births from the 1998 level of 11.2% of live births to 7.6% by the year 2010. In spite of this focus, the rate of preterm births has steadily increased over the past few years to 12.5% of live births in 2004.
While the rate of preterm births has been increasing in recent years among Caucasian families, there are clear racial differences in preterm birth rates with African American mothers being much more likely than other mothers to deliver preterm. In 2003, the rates were 11.3% of live births among Caucasian mothers, 11.9% among Hispanic mothers, and 17. 8% among non-Hispanic Black mothers.
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