As preterm births soar globally, U.S. ranks 130 of 184

The world's developed countries have seen their average rate of premature births double to 6 percent since 1995, despite efforts to reduce the phenomenon, according to a report released on Wednesday.

Worldwide, 15 million of the 135 million babies born in 2010 were premature and 1.1 million died, according to the "Born Too Soon" report, which was compiled as part of the United Nations' "Every Woman Every Child" initiative.

The report, three years in the making and written by experts from 11 countries, is intended to draw attention to the problem and attract donations from governments and charities to solve it. The study analyzes preterm births (before 37 weeks of the full 40-week gestation) in 184 nations, more than ever previously studied.

Of the 65 developed countries that have kept reliable data over the years, only Croatia, Ecuador and Estonia have cut their rate of preterm births since the 1990s. In the other 62, despite programs to, for instance, improve pre-natal care and reduce the number of Cesarean sections, premature births increased from an average of about 3 percent to 6 percent.

The lack of progress is caused in part by "myths and misperceptions" on the part of public health agencies, said Dr. Christopher Howson, vice president for global programs at the March of Dimes and an author of the report. The misunderstandings include the notion that preterm births are rare and therefore not a significant problem deserving attention and resources.

"This report dispels that idea," Howson said. "Not only is preterm birth not rare, but it's common and it kills."

But how common, and especially how deadly, varies enormously across the world, producing what Howson calls "an appalling mortality gap." Preterm births account for almost half of newborn deaths worldwide, making it the second leading cause of death in children under the age of 5, after pneumonia.

While more than 90 percent of babies born before 28 weeks in wealthier countries survive, however, in poor countries more than 90 percent die.

Rates of preterm birth range from 4 percent in Belarus to 18 percent in Malawi, and generally track poverty rates, the report found. Nine of the 11 countries with preterm rates above 15 percent are located in sub-Saharan Africa. Comoros and Congo have a rate of 16.7 preterm births per 100 live births; Zimbabwe, 16.6. The U.S. rate is 12 percent, the worst of the G8 countries and 59th of the 65 countries with reliable historical data.

CAUSES OF PREMATURITY

The high rates of preterm births in poor countries reflect the fact that poverty is associated with many of the reasons women to go into labor too soon: inadequate prenatal care, infections such as malaria and HIV, high blood pressure, obesity or underweight, substance abuse including smoking, and diabetes.

But the rich-poor divide is not huge. The preterm rate averages 12 percent in poor countries and 9 percent in wealthier ones. In fact, countries with the lowest rates of preterm births are not the wealthiest. After Belarus, the next-lowest rate is in Ecuador (5.1), followed by Latvia (5.3); Finland, Croatia, and Samoa (5.5); and Japan and Sweden at 5.9.