PHOM Indicator Profile Report of Preterm birth

Why Is This Important?

Preterm birth, birth before 37 weeks gestation, is the leading cause of perinatal death in otherwise normal newborns and is a leading cause of long-term neurological disabilities in children. Infants born preterm bear the biggest burden of infant deaths, with 68% of infant deaths from 2017-2021 born before 37 weeks. Babies born preterm also have increased risks for long-term morbidities and often require intensive care after birth. Healthcare costs and length of hospital stay are higher for premature infants. For a preterm infant, average hospital stays are about 10 times longer than all infants combined. Utah inpatient hospital discharge data (2022) indicate that average hospital charges for a premature infant were $125,128 compared to $16,220 for all deliveries combined. These same data indicate that the average length of stay for a premature infant was 22 days compared to 2 days for all newborn infants.

Data Notes

2023 U.S. data is provisional.

U.S. data prior to 2007 is based on gestational age from last menstrual period (LMP) versus gestation based on the obstetric estimate (OE). U.S. data of gestation based on the OE has been revised back to 2007. Utah data is calculated by OE.

Beginning in 2007, national rates are reported using OE and are not consistent with rates reported before 2007.

Risk Factors

Data show the following risk factors contribute to having a preterm birth:

• Previous preterm births
• Pre-pregnancy BMI (obese prior to pregnancy)
• Intervals less than 6 months between pregnancies or > 48 months
• Multiple gestation (e.g. twins)
• Tobacco use during pregnancy
• Maternal chronic disease, such as hypertension or diabetes

How Are We Doing?

The Utah preterm birth rate increased from 8.8% in 1990 to a high of 10.1% in 2005. The rate has remained under 10% from 2006 to the present. The percentage of infants born preterm in Utah was 9.35% in 2023 and 2022, a decrease from 9.88% in 2021.

What Is Being Done?

Approximately half of the preterm births in Utah are due to complications of the pregnancy (multiple births, placental problems, fetal distress, infections) or maternal health factors such as high blood pressure or uterine malformations. The remaining preterm births have unexplained causes. In an effort to reduce the preterm birth rate, emphasis is being placed on maternal preconception health to help women achieve optimal health prior to pregnancy. Some ways women can achieve optimal health include stopping the use of tobacco and alcohol, controlling chronic diseases such as diabetes and high blood pressure, and obtaining an optimal pre-pregnancy weight. Early and continuous prenatal care is encouraged to detect problems that may arise during pregnancy. Education should be provided on the urgent maternal warning signs (https://www.cdc.gov/hearher/maternal-warning-signs/index.html) and the importance of recognition and treatment for these symptoms. Standards for assisted reproductive technology should be followed to reduce the frequency of twins or higher-order multiple pregnancies. Pregnant women should also be referred for appropriate services such as Women, Infant, and Children (WIC) and psychosocial counseling.