Public Health Strategies to Prevent Preterm Birth

During the final months of pregnancy, a growing baby goes through important stages of development. The earlier a baby is born, the higher the risk of death or serious disability. Preterm birth, the birth of an infant before 37 weeks of pregnancy, is the largest contributor to infant death. Infants born before 32 weeks gestation bear the biggest burden – representing more than 50 percent of infant deaths. Premature births also pose a long-lasting financial burden on the individual, their families and society. In 2005, the Institute of Medicine reported that each year the cost associated with premature birth in the United States was over $26 billion.

Since 1990, the nation’s overall infant mortality rate has declined nearly 35 percent and the rate of preterm births decreased to 11.3 percent in 2013. However, these national declines have not erased racial disparities within the US. Preterm-related causes of death are more than three times higher for black infants than for white infants. Disparities are also seen for Native American infants.

Preterm birth is complex and remains a challenge because its causes are numerous, and poorly understood. Modern technology and stronger public health strategies have made a significant impact in reducing preterm births and infant mortality. However, we still have a lot to learn about the causes of premature birth in order to prevent it and protect the youngest members of our society, especially among racial and ethnic minorities.

This session of Grand Rounds discusses how concerted efforts to improve surveillance data, better medical care and prevention, and stronger public health partnerships, can accelerate progress in reducing preterm births and improving neonatal outcomes.