Access, Prevention Key to Reducing Preterm Birth

by Amanda Conschafter, blog editor

Lowering infant mortality rates begins with reducing preterm births, a recent briefing on Capitol Hill conveyed. Though the United States has made significant progress, the country still maintains one of the highest infant mortality rates among developed nations. Representatives from the Society for Maternal-Fetal Medicine, the March of Dimes, academia and industry – as well as Rep. Ami Bera, MD (D-CA) and Rep. Lois Capps (D-CA) – discussed how identifying and treating risk factors can help address this national challenge.

Certain strategies have proven effective already. Siobhan Dolan, MD of the March of Dimes said that addressing risk factors such as teen pregnancy and smoking cessation helped. So did lowering early elective deliveries by encouraging at least 39 week delivery, decreasing multiple gestation during in vitro fertilization (IVF) processes, and providing progesterone treatment to address cervical disease due to short cervix. In fact, Sonia Hassan, MD of Wayne State University School of Medicine explained that cervical disease is the most powerful predictor of preterm birth. Fifty percent of women with cervical disease due to short cervix will deliver before 32 weeks.

Screening and offering progesterone gel to treat short cervix could prevent some of these preterm births, Dr. Hassan noted. Vincenzo Berghella of the Society for Maternal-Fetal Medicine reiterated the importance of this strategy. And representatives from Cervilenz Inc. supported using a device that helps identify short cervix, allowing for more proactive treatment.

Detecting and treating cervical disease would reduce the impact of preterm birth on mothers and families – particularly in minority communities.   Dr. Dolan explained that 16.5 of every 1,000 African American babies die as a result of preterm birth, as opposed to 11.5 of every 1,000 across the general population.

But broader, more proactive access to treatment could also help address ballooning health care costs. Jeff Myers of Medicaid Health Plans of America noted that reducing preterm births would significantly decrease Medicaid expenses in particular. The program shoulders the cost of roughly 50 percent of preterm births in the United States.

Under Reps. Bera and Capps’ leadership, several members of Congress are submitting a letter to Health and Human Services (HHS) Secretary Sylvia Mathews Burwell. The letter encourages HHS to adopt the 2012 published guidelines from the Society for Maternal-Fetal Medicine, the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives to prevent preterm birth. These recommendations include “the potential use of routine, universal screening for premature cervical shortening mid-pregnancy and equitable access to progesterone treatment.”


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