Premature births have increased by more than 10% over the last decade.with persistent and growing disparities over time, concludes this analysis carried out on more than 5 million births. Certain factors clearly appear to be involved in this increase in prematurity, including diabetessexually transmitted infections (IS) and the mental health disordersthe prevalence of which has also become much higher over the last 10 years, other protective factors against prematurity having simultaneously decreased.
Lead author Laura Jelliffe-Pawlowski, an epidemiologist, professor at New York University’s Rory Meyers College of Nursing and professor of epidemiology, biostatistics and global health sciences at the University of California, San Francisco (UCSF), states: “Our analysis not only shows that premature births are on the rise, but also provides clues as to the reasons for this increase. Better understanding these factors will help inform clinical care and the development of public health interventions aimed at combating prematurity.”
Babies born prematurely or preterm – before the 37th week of pregnancy – are much more likely to experience a series of short and long term problemsincluding a higher risk of illness, intellectual and emotional difficulties, and death.
Certain factors are already known to increase the risk of premature birth, includinghigh blood pressurediabetes, infection or the maternal smoking. Additionally, certain ethnic communities have a higher risk of premature birth.
Understanding recent trends in prematurity
The study analyzes data from more than 5.4 million singleton births occurring from 2011 to 2022 in the state of California and examines changes in premature birth rates, trends in risk factors, by ethnicity and socio-economic classes. Among his conclusions:
- premature births have increased by 10.6% over the last 10 yearsincreasing from 6.8% in 2011 to 7.5% in 2022;
- this prematurity rate has increased in almost all age groups, but varies by ethnic and socioeconomic group;
- several factors are found to be linked to an increased risk of premature birth, including diabetes, high blood pressure, having previously experienced a premature birth, having had fewer than 3 prenatal care visits, and insecurity housing;
- Rates of pre-existing diabetes, sexually transmitted infections and mental health problems, which appear to be involved in the risk of prematurity, more than doubled during the period studied.
“Data that should set off alarm bells,”
write the authors.
- Especially since, at the same time, factors known to protect against prematurity have diminished: prenatal care, complementary nutrition programs which support poorer women and children are less accessible and benefit from a less participation.
These data therefore remind the need and urgency to improve pregnancy care for all and to promote treatments and interventions that address risk factors associated with preterm birth.
Informing pregnant women about risk factors for premature birth and interventions that can help them manage this risk are part of these interventions.
“For women who are at increased risk due to factors such as hypertension or previous preterm birth, for example, healthcare professionals should have conversations about the usefulness of taking low-dose aspirin, on the benefit of screening for sexually transmitted infections or even on the provision of mental health care.”
The authors are also working on developing a digital platform called Hello Egg to help future mothers better understand and prevent this risk of premature birth.
