A new report from the World Health Organization looking at global rates of preterm births contains some surprising findings. Most European nations, along with Canada and Australia experience preterm births at a rate of about 7-9%. In the US, however, 1 in 9 children is born early – that’s 12% of total births.
The other countries in the 12% bracket? Kenya, Turkey, Thailand, East Timor, and Honduras. Countries with higher rates include part of Africa, Indonesia, and Pakistan. Why would preterm births be so high in the US compared to nations with a similar standard of living? Debates about women’s health care and access to insurance aside, surely health care in the US is a little more advanced than Honduras?
The WHO’s findings are interesting. While in other nations, these high rates of preterm birth can be attributed to untreated infections and girls experiencing more pregnancies from a young age. And, in these nations, only 10% of premature infants are expected to live.
The US stats tell a different story. For one, premature infants born in America have a 90% chance to survival due to the availability of antibiotics, steroids, and other medications to fight common complications. Still, preterm births are a major contributing factor to the high infant mortality rate in the US, and many of these children experience disabilities or continuing illness even if they do survive.
Doctors don’t completely understand the triggers for preterm birth, but they have a few ideas. America has a higher rate of teen pregnancy than other nations, as well as high numbers of women over 35 attempting to give birth. Fertility treatments can make it more likely that a mother will have twins or triplets, which are often delivered early via Cesarean section to avoid the risks of multiple vaginal deliveries.
The rate of obesity, diabetes, high blood pressure, smoking, and other risk factors may also help explain the numbers. Pregnant women without health insurance may not see doctors when they get sick, raising the risk of going into labor early.
Two other studies, by Dr. Radek K. Bukoski and Dr. Gordon C. S. Smith, suggest that these explanations may not show the full picture. Dr. Bukoski looked at Mexican-American immigrants and found that their risk of preterm birth increased dramatically the longer they lived in America – only 4% for recent immigrants, compared to 10% in those who had gained citizenship. The study controlled for risk factors including age, poverty, smoking habits, obesity, and diabetes. Dr. Smith’s research comparing preterm birth rates in the UK and America found that even in areas with similar risk factors, the rates were still lower. This is clearly going to have to be an area of continuing research.
The full WHO study can be read on online for free.
Photo credit: Raphael Goetter