Virginia receives a 'D' for premature birth rate

Virginia is doing better at reducing premature births, but the state still gets a grade of D because too many babies are born before full term, according to the March of Dimes.

The March of Dimes today releases its 2009 report cards that grade states on premature birth rates.

The national grade average is a D — and only one state, Vermont, received a B. No state received an A.

Criteria considered in grading include a state's preterm birth rate and state policies on access to health-care coverage for women of childbearing age.

Virginia got a D last year, the first year the March of Dimes did the report cards. This year, Virginia gets a D but also a "star" for lowering the preterm birth rate to 8.6 percent from 12.3 percent last year.

The national goal, based on the federal government's Healthy People 2010 guide, is 7.6 percent or less.

"Prematurity is escalating globally," said Dr. Susan Brown, a neonatologist at Henrico Doctors' Hospital.

On one hand, Brown said, lack of access to prenatal care, particularly for teenagers and women who are uninsured, is a driving factor.

At the other end of the spectrum are well-cared-for women who are having babies at an older age when risk of complications is higher.

"They are receiving prenatal care. Ten years ago they would not have been able to get pregnant," Brown said.

Now, with the help of assisted reproductive technology, they can get pregnant, often with twins and triplets, which increases risk of preterm birth.

Babies born preterm — before 37 weeks gestation — are at greater risk of long-term developmental delays.

On a different measure of infant and maternal health, Virginia officials this year announced that the state's infant mortality rate had dropped to a record low — 6.7 deaths per 1,000 live births.

"What it clearly says is we may be headed in the right direction, with a historic drop in infant mortality. . . . A lot of great work has been done, and we have a lot to do," said Dr. Karen Remley, Virginia health commissioner.

Infant mortality measures the numbers of babies who die before turning 1 year old. Preterm birth is a leading factor in infant mortality.

"They're all connected," she said. "While I would love to see us get a better grade, I see why we have the grade we have. And hopefully next year will do better."

Brown said about 75 percent of preterm births are considered late preterm, babies born 34 to 37 weeks gestation. A full-term pregnancy is 37 to 42 weeks. In some cases, late pre-term births are induced, sometimes for reasons that are not necessarily medical.

"They are close to term. Maybe [the mother] is uncomfortable. So they go ahead and deliver a little bit early. They don't have as high mortality, but they have medical issues that leave them in the hospital or that cause them to return to the hospital," Brown said.

Virginia March of Dimes officials will release the figures at briefings today in Winchester, Norfolk and Richmond.

Contact Tammie Smith at (804) 649-6572 or TLsmith@timesdispatch.com.