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Nation gets a low grade in preventing premature birth

10:00 AM, November 12, 2008

Premie21 The rate of premature birth in the United States is shockingly high for a developed country that possesses sophisticated healthcare technology. The nationwide rate is 12.7% even though federal health officials say it should be no more than 7.6%. Prematurity rates have worsened in recent years, increasing by more than 15% between 1995 and 2005.

Those statistics have earned the country a D in the March of Dimes first annual Premature Birth Report Card issued today. States were also given grades. Vermont had the lowest rate, at 9%, which earned it a B. California's rate is 10.7%, earning it a C. Eighteen states plus Puerto Rico and the District of Columbia received grades of F.

Premature birth exacts an enormous cost on babies and on society, according to the March of Dimes. It is the leading cause of newborn death and a major cause of lifelong disability. Such births cost the nation $26 billion a year.

Earlier this year, the March of Dimes established a petition seeking more federal attention to the problem and more money for research on prevention.

— Shari Roan

Photo credit: Ken Hively/Los Angeles Times

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The March of Dimes has issued a press release about preventing prematurity without mentioning the most important risk factor in prematurity: race. Prematurity is much higher in women of African descent than in any other group, white, Hispanic, Asian or Native American. This effect persists even when corrected for income and socio-demographic factors. Wealthy educated African-American women have a much higher rate of prematurity than their counterparts of other races. The map of prematurity that the March of Dimes distributed correlates almost perfectly with census maps that show the distribution of African Americans within the country.

Of course Vermont has the lowest rate of prematurity. It is the least integrated state in the Union. It has nothing to do with prematurity prevention programs in Vermont. Of course Washington, DC has the worst rate of prematurity. It has one of the highest concentration of African-Americans in any part of the US.

The March of Dimes is equally disingenuous about the issue of iatrogenic prematurity. Iatrogenic prematurity (caused by deliberately delivering a baby early) has a strong, medically approved rationale. The March of Dimes bemoans the fact that many babies are deliberately delivered prematurely. They decry the health problems caused by prematurity, but they neglect to mention that stillbirths have decreased dramatically as a result.

I was at the press conference this morning and Doctor Fielding made mention of this many times about the high incidence of the rate of premature births in the African American Population. He did a great job this morning on the subject. I will be writing my summary of the press conference and it should be up tomorrow.

I got teary eyed . Tough listening to a press conference like that. It is an important issue.

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Tami Dennis, who takes the word "skeptic" to previously uncharted territory, is the Times' Health and Science editor. She's adamant that pitches promoting awareness days, weeks or months are, by their nature, non-stories. And, because she's an adult, she refuses to use words like "veggies," "tummy" and "yummy."
Rosie Mestel, deputy Health and Science editor, studied genetics before abandoning flies, fungi and DNA for health/medical writing. Her hero is the biologist Ernst Haeckel, whose jellyfish paintings inspired snazzy chandeliers. Her favorite toast-spread is Marmite, a British delicacy made of yeast extract. Her least-favorite word is "millenniums."
Melissa Healy is a staff writer for the Health section reporting from Washington D.C. Healy's a veteran of The Times' National staff, having covered the Pentagon, Congress, poverty and social welfare, the environment, and the White House before shifting to Health in 2003. She writes frequently about mental health and human behavior, about federal health policy, prescription medication and ethics in medicine. More wonk than wellness freak, Healy chooses to believe in the health benefits of coffee and wine, and considers water a better work-out medium than beverage.
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Thomas H. Maugh II has been a science and medical writer at the Times for 23 years. Before that, he was on the staff of the journal Science for 13 years. He has bachelor's degrees in English and chemistry from MIT and a doctorate in chemistry from UC Santa Barbara.
After a brief stint as a sports writer, Shari Roan turned to health journalism and has covered the topic for The Times for 18 years. She is the author of three books and the mother of two daughters, both teenagers who refer to her as a "health freak." She likes to jog, watch baseball and is very happy that dark chocolate contains some health benefit.
Jeannine Stein writes about fitness, sports medicine and obesity for the Health section. She’s a gym rat from way back and never met an elliptical trainer she didn’t like. Well, maybe one or two. She tempers exercise with a steady diet of reality television because she believes it’s all about balance.