The 130th Annual Meeting of APHA

Abstract #47312

Rebecca Russell, MSPH, Joann Petrini, MPH, Karla Damus, RN, PhD, and Michael Davidoff, MPH. Perinatal Data Center, March of Dimes Birth Defects Foundation, 1275 Mamaroneck Ave, White Plains, NY 10605, 914.997.4683, rrussell@modimes.org

In 1999 prematurity/low birthweight became the leading cause of neonatal death in the US and the rate of preterm births (PTB, < 37 completed weeks gestation) has increased more than 11% in the past decade to a high of 11.8%. To highlight this public health enigma, for the first time, objectives for PTB (7.6%) and very PTB (1.1%, <32 weeks) were added to the Healthy People 2010. But what does an overall PTB rate of 11.8% in 1999 really mean? The community must have an understanding of the epidemiology of PTB and risk factors. At a minimum, rates should be stratified by plurality, which reveals a US PTB rate of 10.3% for singleton and 59.4% for multiple births. A retrospective analysis of natality data from the National Center for Health Statistics was conducted to examine trends in PTB and very PTB between 1990 and 1999, stratified by plurality, maternal race/ethnicity, maternal age, education, parity, and mode of delivery. Although the rates of PTB increased significantly among white infants (20.2%), Asian infants (4.0%), and Native American infants (9.3%), African-American infants experienced a significant decrease (6.9%) (p<0.001). Changes in PTB rates also varied by maternal age, from an 8% decrease among women less than 15 years to a 52.3% increase among mothers 45 years or greater (p<0.001). Additional results of descriptive and multivariate analyses will be presented as will recommendations for minimal epidemiological analyses to assist communities in their planning, implementation and evaluation of programs to address this serious perinatal outcome.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe national trends in preterm and very preterm births.
• Identify demographic groups with the highest rates of preterm births in the US.
• Understand the utility of a stratified, epidemiological analytic approach towards preterm births for public health programs.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.