In late June of 2016, the National Center for Health Statistics released provisional birth data showing that U.S. preterm birth rates rose 2 percent in 2016, from 9.63 to 9.84 percent of all pregnancies. This is the second year in a row that national preterm birth rates have increased—a worrying trend, given that preterm birth is the leading cause of infant deaths and can also contribute to lifelong disabilities.

Within the U.S., 17 states had an increase in preterm birth, and no state had a decline in 2016. (Puerto Rico, which did see a decline in preterm birth rates in 2015, had a slight increase in 2016 from 11.39 to 11.50 percent.) The increase was specifically in late preterm births (34-36 weeks of gestation), while the early preterm birth (less than 34 weeks gestation) rate remained constant.

The report also showed significant racial disparities. Non-Hispanic black mothers had the highest rates of preterm birth at 13.76 percent, compared with 9.04 percent for non-Hispanic white mothers. In addition, there was a national increase in low birthweight rates for the second year in a row, from 8.07 percent in 2015 to 8.16 percent in 2016. Racial disparities appeared here as well, with 13.66 percent of non-Hispanic black pregnancies resulting in low birthweights, versus 6.97 percent of non-Hispanic white births and 7.31 percent of Hispanic births.

Racial disparities are also evident in the number of women who receive prenatal care in the first trimester, where 82.3 percent of non-Hispanic white women received early prenatal care, compared with only 66.6 percent of non-Hispanic black women. A full 19.2 percent of non-Hispanic Native Hawaiian or Other Pacific Islander women received late or no prenatal care at all.

In response to this report, the March of Dimes suggests several interventions, including reducing tobacco use, increasing group prenatal care access, reducing non-medically necessary deliveries, and encouraging optimized birth spacing (at least 18 months between pregnancies).

PROTECT/CRECE staff and their family members at the March for Babies event in San Juan. The Puerto Rico Chapter of the March of Dimes works to reduce the rate of preterm birth on the island.

Since the Center’s inception, PROTECT has partnered with the March of Dimes in Puerto Rico in effort to raise awareness of and to educate health professionals on strategies to reduce rate of preterm births on the island. PROTECT co-director Dr. José Cordero is a former member of the March of Dimes Board of Trustees and a current Chair of the Puerto Rico Prematurity Taskforce, a community group that has contributed to a reduction of preterm births on the island through their advocacy for reducing early elective deliveries before 39 weeks gestation.  This reduction of the preterm birth rate has been drastic, dropping from 19.9% in 2006 to 11.4% in 2015, leading to Puerto Rico being awarded the Virginia Apgar Award. PROTECT’s March of Dimes partnership has expanded to educating healthcare professionals about the Zika virus and its effects on fetal development. Recently, Dr. José Cordero has been working to take his passion for improving pregnancy outcomes from Puerto Rico to the mainland U.S., joining the Georgia chapter of March of Dimes in addressing their high rate of preterm birth.

PROTECT looks forward to future partnerships with the March of Dimes, as well as to continued advocacy for maternal and infant health in Puerto Rico and the U.S. as a whole.