Preterm Birth in North Carolina

Abstract

Decreasing infant mortality is closely linked to decreasing preterm births. Unfortunately, the rate of preterm births in North Carolina and in the United States, after declining in the 1980s, has been rising again for the past several years. The goal of this commentary is to examine North Carolina data related to both preterm births per se and to those factors that have been associated with preterm birth. At times, low-birth weight (LBW) rates will be used in this paper when preterm data are not available. While both rates follow similar patterns, readers should recognize that LBW refers to the birth of infants weighing less than 2,500 grams (5 pounds, 8 ounces), while preterm births are those before 37 weeks gestation. Some of the data reported here (smoking and intimate partner violence, for example) are based on self-report by women who are pregnant or delivering; such self-reporting may result in underestimation of the true rate of the outcome or exposure reported. Preterm births may be medically indicated because of the health of the mother or fetus, may follow preterm premature rupture of the fetal membranes, or may be the result of spontaneous onset of labor. The antecedents of preterm birth are multifactoral and vary from one birth to another. Thus, the reasons for increasing rates of preterm birth are not clear. Two factors have been identified in both national and North Carolina data as potentially contributory: increasing maternal age and an increasing number of multiple gestation births. 1,2