CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth

TLDR

Preterm birth, defined as delivery before 37 weeks, accounts for 11.4 % of U.S. live births and 36 % of infant deaths, with the highest mortality and morbidity among infants born before 32 weeks, and is driven by social, behavioral, clinical, and biological risk factors while racial and ethnic disparities persist. The study aims to reduce preterm birth by implementing and monitoring strategies that target modifiable risk factors and high‑risk populations. It proposes improving quality and access to preconception, prenatal, and interconception care through high‑impact interventions.

Abstract

Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth (1). Infants born at earlier gestational ages, especially <32 0/7 weeks, have the highest mortality (Figure) and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance. Risk factors for preterm delivery include social, behavioral, clinical, and biologic characteristics (Box). Despite advances in medical care, racial and ethnic disparities associated with preterm birth persist. Reducing preterm birth, a national public health priority (2), can be accomplished by implementing and monitoring strategies that target modifiable risk factors and populations at highest risk, and by providing improved quality and access to preconception, prenatal, and interconception care through implementation of strategies with potentially high impact.