State flunks test for high preterm birth rate

Georgia’s high rate of premature births has earned the state an “F” grade in a report card issued Wednesday by the March of Dimes.

Premature births —- those before 37 weeks’ gestation, compared with full term of 40 weeks —- can have a number of medical consequences, including an increased risk of death.

A nonprofit working to improve babies’ health, the March of Dimes was a tough grader. It ranked states based on a preterm birth rate goal of 7.6 percent of all live births.

No state earned an A. Only Vermont received a B.

Seventeen other states also earned a failing grade on their number of preterm babies, including all Southeastern states except Virginia.

Georgia’s rate of preterm births was 13.6 percent. The first-of-its-kind report card used 2005 birth data.

The March of Dimes said there has been more than a 20 percent increase in preterm births in the U.S. since 1990. It created the ratings to put the issue on the nation’s health agenda.

“It is unacceptable that our nation is failing so many preterm babies,” said Jennifer Howse, March of Dimes president.

Georgia has a higher-than-average rate of infant mortality, or the number of children who die before their first birthday.

Babies who survive premature birth face a risk of blindness, developmental disabilities, cerebral palsy, asthma and other ongoing problems. Even those born a few weeks from their due date have a greater risk of breathing and feeding problems, jaundice and delayed brain development.

To reduce premature births, every pregnant woman should have access to health insurance coverage and early prenatal care, said Dr. William Sexson, a neonatologist at Atlanta’s Grady Memorial Hospital and Emory Crawford Long Hospital.

“A healthy baby starts long before pregnancy is known,” Sexson said. “The mother has to be as healthy as possible prior to conceiving a child. And at that point, it’s critical that the mother and fetus get as good care as possible.”

Preterm births are associated with smoking, previous preterm birth, substance abuse, high blood pressure and diabetes, said Sexson, chairman of the March of Dimes prematurity awareness campaign in Georgia.

The rate of Georgia women ages 18 to 44 who smoke is 19.3 percent, while 22.6 percent of women here in that age range have no health insurance, the report card said.

An African-American woman in Georgia is much more likely to have a premature baby than a white, Asian or Hispanic woman. That disparity has endured for years, Sexson said.

Meanwhile, the cost of a premature birth can be staggering. Stays in a neonatal intensive care unit, including physician fees, can cost up to $4,000 a day, Sexson said.

Four years ago, Charemon Grant’s baby, Mark, was born at 26 1/2 weeks, at 1 pound, 13 ounces.

He was in a neonatal intensive care unit for about three months, and was released on the day before he was expected to be born.

“He’s a million-dollar baby,” said Grant, senior executive counsel for Blue Cross and Blue Shield of Georgia. “Fortunately for our family, we were insured.”

Now 4 years old, Mark has “sensory integration issues,” including being sensitive to touch and having challenges with fine motor skills. “It’s a daily challenge,” Grant said. “It has been a journey hard fought. We have pulled together as a family.”

“Mothers need to be fully educated about factors that can lead to premature birth,” she added.

The March of Dimes called for expanded federal research into preterm births, smoking cessation programs, and a review of all Cesearean-section births and inductions of labor before 39 weeks’ gestation to make sure they are medically necessary.

Georgia’s C-section rate of 30 percent is “uncomfortably high,” Sexson said.

Georgia’s ranking is not surprising, said Dr. Diane Weems, chief medical officer for the public health district that includes Savannah.

She noted the state’s preterm birth rate has risen from 11.7 percent in 1995.

“We’re moving in the wrong direction,” said Weems, a pediatrician, adding that public health is underfunded. “The cost [of preterm births] to communities and families over time is huge. We’ve done a poor job in Georgia.”

“We’ve talked a lot about prevention, but we haven’t done much about it.”