Arkansas’ preterm birth rate rose from 10% to 10.8% in 2015, according to the March of Dimes, at the same time that the national rate also rose for the first time in eight years. The increase moved Arkansas from a “C” to a “D” in the organization’s 2016 Premature Birth Report Card.
The state ranked 42nd among the 50 states and Washington, D.C.
Arkansas was one of seven states that received a lower grade this year than last and was one of six states plus Puerto Rico that received a “D.” Nationally, the rate rose from 9.57 to 9.63 in 2015, earning a “C.” Vermont had the lowest rate at 7.3%, followed by Oregon at 7.6% and New Hampshire at 7.3%. Mississippi had the highest rate of 13%, just ahead of Louisiana (12.3%) and Alabama (11.7%). Those three states all received an “F.”
Arkansas ranked 33rd in its disparity among ethnicities in pre-term births from 2012-14. African-American women had a 46% higher preterm birth rate than other women. The rate was 13.7% of births among African-Americans; 9.7% among Asian/Pacific Islanders; 9.5% among whites; 9.3% among American Indian/Alaska natives; and 8.3% among Hispanics.
Nationally, African-American women had a 48% higher preterm rate than all other women, at 13.3% of births. Hawaii had the highest ethnic disparity, while Maine had the lowest.
The March of Dimes has set a goal of 8.1% preterm births by 2020. Pre-term is defined as births at less than 37 weeks gestation. The figures come from the National Center for Health Statistics.
Among the state’s largest counties, Sebastian County had the lowest rate in 2014 at 8%, while Craighead’s was the highest of the large counties at 12.3%. Pulaski County had a 10.4% rate, Benton County had a 9.6% rate, Washington County’s was 10.5% and Faulkner County’s was 8.7%. Twenty-four counties had percentages of more than 10.9%, while 26 had percentages of 9.4-10.9% and 25 had percentages under 9.4%.
According to the March of Dimes, preterm births are the nation’s leading cause of baby deaths and are responsible for more than $26 billion each year in avoidable medical and societal costs. The organization said the United States has a higher pre-term birth rate than most high-income countries, but there is no explanation for why 65% of those early births happen.
Dr. Whit Hall, medical director of the University of Arkansas for Medical Sciences nursery and the chair of the state March of Dimes Maternal Health Committee, said the increase in Arkansas and nationally is “worrisome.” He said babies born at less than 32 weeks have 10-15 painful procedures a day, including needle sticks and tubes down their throats. Dr. Ashley Ross, chief of neonatology at UAMS and Arkansas Children’s Hospital, said premature babies can spend weeks or months in a hospital. Extreme prematurity in the 24-27-week range creates an increased risk of complications that lead to lifelong health concerns, especially related to development.
Hall said general overall health is important to full-term delivery, including avoiding obesity and smoking and preventing teen pregnancy. Another is inter-pregnancy intervals of 18-24 months – shorter or longer increases the chance of a pre-term delivery. However, he said more research is needed for the unanswered questions.
“When the dust settles, there’s a large percentage of mothers who deliver pre-term babies that we just don’t know the reason why,” he said.
He said the March of Dimes is making a push to ensure babies are born after 39 weeks, even when induced. Babies born at 38 weeks and 37 weeks have increasing chances of being admitted to a neonatal intensive care unit.
“It’s a huge difference in how many babies are being admitted to where I take care of them,” he said.
Ross said “the vast majority” of situations cannot be blamed on actions by the mother. He said parts of the state lack prenatal care, increasing the odds of premature delivery because problems aren’t caught early.
“You’re asking people to travel long distances who may not have resources to travel long distances to get to a center that can provide that good prenatal care,” he said.