State’s grade on premature births drops

Georgia has received a lower grade on the latest March of Dimes report card on premature births, despite making progress since 2009 on reducing these preterm deliveries.

The state was given a “D” grade on the 2015 report card, dropping from a “C” grade a year ago.

A premature infant. Photo courtesy of the March of Dimes
An infant who was born premature. Photo courtesy of the March of Dimes

Georgia’s preterm birth rate was 10.8 percent in 2014, according to the National Center for Health Statistics. That rate places Georgia 44th among the states, according to the March of Dimes. The report, released Thursday, reflects new methodology that calculates the preterm rates.

The national preterm birth rate was 9.6 percent in 2014.

“Too many of our babies must fight to overcome the health challenges of an early birth,” says Dr. Valerie Montgomery Rice, president of the Morehouse School of Medicine in Atlanta, who is a Georgia March of Dimes board member.   

Rice acknowledges large gaps between the preterm birth rates of different Georgia communities, noting that “racial and ethnic disparities persist.”

Dr. Valerie Montgomery Rice
Dr. Valerie Montgomery Rice

Atlanta, Augusta, Columbus and Savannah all had preterm birth rates that were worse than the statewide average.

“There is still work to be done,” says Julie Zaharatos, director of program services and government affairs, for the Georgia chapter of the March of Dimes.

“While we met the goal that was set in 2009, looking to 2016 we have a lot of work to do to keep pace with states that have made greater strides in reducing their preterm birth rates,” Zaharatos says.

According to the March of Dimes, every year more than 16,000 premature babies are born in Georgia. But there are differing levels of prematurity and different degrees of low birth weight. Some are far more serious than others.

The American College of Obstetricians and Gynecologists states that most full-term pregnancies last about 40 weeks. Babies born between 32 and 37 weeks of pregnancy are considered preterm. Those born before 32 weeks are called “early preterm.”

“I think what we get into [in Georgia] are the patients who don’t have [any] prenatal care or seek care later in the pregnancy,” says Dr. Larry Matsumoto, perinatologist at the Center for Perinatal Medicine at Northside Hospital in metro Atlanta.

“They [likely] went into the pregnancy” with high risk factors for preterm delivery that weren’t really addressed, says Matsumoto. “In those cases, some of the damage has already been done.”

He’s referring to damage to the cervix or placenta that can sometimes occur when problems with the pregnancy cannot be reversed in time. “If everyone was insured or had access to prenatal care, that may be one way to . . . [lower] that preterm delivery rate,” Matsumoto says.

Georgia’s uninsured rate remains among the highest in the nation.

Another thing Matsumoto sees is that some women decline to quit smoking when they realize they are pregnant. Smoking, always an unhealthy habit, can increase the chances of preterm delivery — a smaller baby being born too soon.

Dr. Larry Matsumoto
Dr. Larry Matsumoto. Photo courtesy of Northside Hospital

Smoking alone can result in “pushing the indicated preterm delivery risk rate up as opposed to the spontaneous preterm rate,” says Matsumoto.

Georgia’s lower grade comes despite the fact that just last month, the Department of Public Health was recognized for lowering the state’s preterm birth rate over the last five years.

This recognition, known as the Virginia Apgar award, recognized states that lowered their preterm birth rates at least 8 percent between 2009 and 2014. Georgia has succeeded in doing that, but other states have progressed more rapidly this year.

Virginia Apgar developed the five-point APGAR scoring system, which assists medical professionals in their one-minute evaluation of an infant’s health at the time of birth. She devised it in 1952, and it has been in use ever since.

“The Apgar Award is a reflection of hard work and dedication of health care professionals in maternal and newborn care, along with organizations throughout Georgia,” says Dr. Brenda Fitzgerald, commissioner of the Department of Public Health.

She says reducing the rate of premature babies is a priority.

A meeting this month in Atlanta will promote patient education, healthy birth spacing, group prenatal care, and access to progesterone shot for women with a history of preterm birth.

The March of Dimes says the U.S. preterm birth rate ranks among the worst of the high-resource countries.

Worldwide, 15 million babies are born preterm and nearly 1 million die, according to the World Health Organization.

Photo courtesy of the March of Dimes
Photo courtesy of the March of Dimes

Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.