Preterm Birth in Kentucky-A Public Health Challenge

Preterm birth rates have risen over the last decade in Kentucky at a rate twice as fast as the national rate (24% vs. 12.3%). Kentucky has the highest prematurity rate of our surrounding states, except Tennessee, where the rates are comparable (KY 14.4%, TN 14.5%, 2004). Preterm birth is the major cause of neonatal mortality and is associated with increased morbidity in infants who are only mildly preterm. Data from birth certificates was analyzed to determine the cause of the rise in prematurity rates. Common risk factors for preterm birth, such as PIH, diabetes, multiple births, infertility births, and births in older mothers were examined, but none appear to have a major role in the rising numbers of preterm births in Kentucky. The main factor in the rising prematurity rate is the increase of late preterm births (34-36 weeks gestation). This grouping comprises 78.3% of all premature infants born in Kentucky. Public health programs such as home visiting to high risk mothers have proven effective in reducing preterm birth in high risk populations. The Kentucky Department for Public Health is partnering with the National March of Dimes and Johnson & Johnson Pediatric Institute to conduct a three year demonstration project promoting comprehensive, medical and multidisciplinary, evidence-based interventions in three Kentucky communities. Risk reduction strategies, information on the late preterm infant, and preventable preterm births will be emphasized, with the goal of decreasing the singleton preterm birth rate by 15% in intervention communities.