The grades were determined by comparing preterm birth rates to the national Healthy People 2010 preterm birth objective, which is 7.6 percent of all live births. The United States continues to fail by earning a “D” grade on the Report Card.

“Preterm birth is a common and complex problem with many contributing factors,” said Elaine Noonan, State Director of the March of Dimes. “It affects babies of all races and ethnicities and families from all walks of lives.  We hope the report card will focus attention on this serious problem and help identify the best practices for reducing the rates of preterm birth.”

The report card tracks three risk factors -- uninsured women, women of childbearing age who smoke, and late preterm birth.  These risk factors impact preterm birth rates and could be changed, either through women or health care professionals changing their behavior or through policy or legislative change.  In Washington state, the rate of uninsured women rose from 14.7 percent to 15.1 percent. Women of childbearing age who smoke decreased from 19 percent to 16.5 percent, but the March of Dimes is closely monitoring this trend as the state’s Tobacco Prevention and Control Program (TPCP) was cut by 43% in the 2009 Legislative session. Lastly, the late preterm birthrate remained unchanged and stalled at 7.8 percent.

Impact of Elective C-sections And Inductions

Monica Anselmetti, M.D., OB/GYN, Olympia Medical Center and Group Health Cooperative, and Washington State Junior Fellow Chair for the American College of Obstetricians and Gynecologists (ACOG), says the state’s preterm birth rate won’t improve unless the ACOG guideline that deliveries prior to 39 weeks are to be performed only if medically necessary is strictly followed.  In 2007, 29% of all births in Washington state resulted in a Cesarean delivery.
 
“The rise in late preterm births (34-36 weeks) has been linked to rising rates of early induction of labor and c-sections,” said Dr. Anselmetti. “Elective c-sections and inductions can be dangerous for the baby. Even a week too soon poses risks.”

A baby is considered full term once a woman reaches 39 weeks of pregnancy. Dr. Anselmetti noted that many babies born just a few weeks early need medical and nursing attention beyond that given to full term newborns.  They have a greater likelihood of breathing problems such as respiratory distress syndrome, feeding difficulties because they can’t coordinate sucking, swallowing and breathing; have trouble maintaining their body temperature; jaundice; reduced brain development; and are more likely to die of sudden infant death syndrome (SIDS).

“I urge every pregnant woman to talk to her doctor about the risks of elective c-sections or inductions so you understand all of your choices. Nine months of a healthy pregnancy is the best gift you can give your future baby,” she added.

Innovative Program at University of Washington Medical Center

Three groups of women are at greater risk of preterm labor and birth – women who have had a previous preterm birth, women who are pregnant with multiples and women with certain uterine or cervical abnormalities.

The UW Medical Center has a cutting edge prematurity prevention program for high-risk pregnant women.  The program provides counseling, education, and diagnostic services to women from all over Washington state.

“We see first-hand the positive impact of educating women who have had a previous premature birth with information on how to lessen the chances of prematurity in future births,’ said Dr. Michael Gravett, UW Professor and Vice Chair of the Department of Obstetrics & Gynecology, University of Washington Medical Center.  “The recommendations in the report card provide us a solid and tangible guide to helping reduce rates of premature birth in Washington.”
 
The March of Dimes is the leading organization for pregnancy and baby health. With chapters nationwide, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org.

Washington State Report Card

US Report Card