PreBir preterm, premature, prematurity, preemie PreBir.UT_US The number of live births under 37 weeks gestation divided by the total number of live births over the same time period. Number of live born infants born less than 37 weeks gestation. Total number of live births. Reporting of preterm birth (PTB) trends has been complicated by a change in how gestational age (GA) is reported by the National Center for Health Statistics. PTB is defined as a birth less than 37 weeks gestation. Historically, GA was calculated by the mother's last menstrual period (LMP) and PTB rates were reported this way. Since the 2003 revision of the birth certificate, GA is also reported by obstetric estimate (OE), which is considered more accurate. Beginning in 2010, national rates are reported using OE and are not consistent with rates reported before 2010. Utah rates have been reported using OE since 1996. 10/24/2020 Preterm birth, birth before 37 weeks gestation, is the leading cause of perinatal death in otherwise normal newborns and is a leading cause of long-term neurological disabilities in children. Infants born before 32 weeks gestation bear the biggest burden representing more than 50 percent of infant deaths. Babies born preterm also have increased risks for long term morbidities and often require intensive care after birth. Health care costs and length of hospital stay are higher for premature infants. For a preterm infant without complications, average hospital stays are three times longer than a term infant, and for a preterm infant with complications, average hospital stays are over seven times longer than a term infant. Utah inpatient hospital discharge data (2017) indicate that average hospital charges for a premature infant was $83,177 (DRG 790, 791, 792) compared to $3,574 for a normal newborn infant (DRG 795). Utah inpatient hospital discharge data (2017) indicate that average length of stay for a premature infant was 16 days (DRG 790, 791, 792) compared to 1.8 days for a normal newborn infant (DRG 795). MICH-9.1 The Healthy People 2030 has an objective of reducing Preterm Births- MICH-07 with a baseline of 10% (2018) and a goal of 9.4%. The Utah preterm birth rate increased from 8.8% in 1990 to a high of 10.1% in 2005. The rate has remained under 10% from 2006 to 2019. The Utah preterm birth rate increased to 9.72% in 2019. The U.S. preterm birth rate rose for the fifth year in a row to 10.23% in 2019, up from 10.02% in 2018, an increase of 2% and the highest level reported in more than a decade (Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: Final data for 2018. National Vital Statistics Reports; vol 68 no 13. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: [https://www.cdc.gov/nchs/data/nvsr/ nvsr68/nvsr68_13-508.pdf]. The Utah rate of 9.72% is below the national rate. In 2010, the U.S. began reporting preterm birth rates based on obstetric estimates rather than based on last menstrual period (LMP) making it difficult to compare Utah to the U.S. farther back than 2010. The obstetric estimate has been shown to more accurately reflect the true gestational age of the infant than LMP. Approximately half of preterm births in Utah are due to complications of the pregnancy (multiple births, placental problems, fetal distress, infections) or maternal health factors such as high blood pressure or uterine malformations. The remaining preterm births have unexplained causes. In an effort to reduce the preterm birth rate, emphasis is being placed on maternal preconception health to help women achieve optimal health prior to pregnancy. Some ways women can achieve optimal health include stopping use of tobacco and alcohol, controlling chronic diseases such as diabetes and high blood pressure under control, and obtaining an optimal pre-pregnancy weight. Early and continuous prenatal care is encouraged to detect problems that may arise during pregnancy. Women should be educated regarding the danger signs of pregnancy and the importance of recognition and treatment for these symptoms. Standards for assisted reproductive technology should be followed to reduce the frequency of twins or higher order multiple pregnancies. Pregnant women should also be referred for appropriate services such as Women, Infant and Children (WIC) and psychosocial counseling. The maternal committee of the Utah Women and Newborns Quality Collaborative (UWNQC) worked to prevent recurrent spontaneous preterm birth (SPTB) in women with a previous history of SPTB. This team developed a series of videos on preterm birth prevention available on the UWNQC website ([https://mihp.utah.gov/uwnqc/]). The committee has produced materials to help educate families who have delivered prematurely on what they can do to reduce the chances of preterm birth from happening in future pregnancies. In addition, the maternal committee has worked on access to immediate postpartum long-acting reversible contraception as well as other family planning access. '''Utah Women and Newborn Quality Collaborative:''' [https://mihp.utah.gov/uwnqc/][[br]] Provider and patient education about improving maternal and neonatal outcomes through collaborative efforts centered on quality improvement methodology and data sharing. '''The Power Your Life website:''' [http://www.poweryourlife.org][[br]] Public education about how to be at optimal health prior to pregnancy.[[br]] [[br]] Social media for Power Your Life include: *Facebook: [http://www.facebook.com/poweryourlifeutah] *Twitter: @Poweryourlife2 *Pinterest: [http://www.pinterest.com/poweryourlifeut][[br]] [[br]] '''Utah Tobacco Quit Line:''' 1-888-567-8788 '''Baby Your Baby Hotline:''' 1-800-826-9662[[br]] A public resource to answer pregnancy related questions and locate services. '''MotherToBaby:'''[[br]] Phone - 1-800-822-2229[[br]] Text - 1-855-999-3525[[br]] Email - expertinfo@mothertobaby.org[[br]] Live Chat- [http://www.mothertobaby.org][[br]] A service to answer questions about what's safe during pregnancy and breastfeeding.[[br]] [[br]] Social media for MotherToBaby include: *Facebook: [http://www.facebook.com/MotherToBaby] *Twitter: @MotherToBaby *Pinterest: [http://www.pinterest.com/MotherToBaby][[br]] [[br]] '''Baby Watch Early Intervention Hotline:''' 1-800-961-4226[[br]] Utah's network of services for children, birth to three years of age, with developmental delay or disabilities. '''March of Dimes, Utah Chapter:''' [http://www.marchofdimes.org/utah][[br]] The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality.[[br]] *Facebook: [https://www.facebook.com/marchofdimes][[br]] *Twitter: @MarchofDimes[[br]] *YouTube: [https://www.youtube.com/marchofdimes][[br]] [[br]] '''University of Utah Health Care Parent-to-Parent Support Group:''' 1-801-581-2098[[br]] Support Program for families of high risk/critically ill newborns. [http://mchb.hrsa.gov][[br]] [http://www.cdc.gov/reproductivehealth/index.htm][[br]] [http://www.marchofdimes.com] CFHS_Repro lbaksh@utah.gov A 01/08/2021 Detail modified by: lbaksh@utah.gov, 11/02/2020 3 x 01/08/2021 Status changed by: vlund@utah.gov 01/08/2021 MICH-9.1 MICH MICH-9.1 Reduce total preterm births 9.4 percent 8.9 percent 868 11/13/2013 x PopChar Data show the following population subgroups at higher risk of having a preterm birth: *Race (Utah mothers who were Black/African American, Asian or Native Hawaiian/Other Pacific Islander) *Maternal age (mothers older than 35) *Low educational attainment (high school diploma or less) *Being unmarried AgeDistPop AgeDistPop.Ut_US EduLevPop EduLevPop.Ut_US LBW LBW.Ut_USYear PNC PNC.LHD RacEthPop RacEthPop.RaceYear SystemFactors Data show the following health care system factors contribute to a higher risk of having a preterm infant: *Access to prenatal care HHInc HHInc.UT_US HlthIns HlthIns.UT_US_ACS PNC PNC.LHD RiskFactors Data show the following risk factors contribute to having a preterm birth: *Previous preterm births *Pre-pregnancy BMI (obese prior to pregnancy) *Intervals less than 6 months between pregnancies or > 48 months *Multiple gestation (e.g. twins) *Tobacco use during pregnancy *Maternal chronic disease, such as hypertension or diabetes BrthDef BrthDef.New14-16 HypAwa HypAwa.UT_US OvrwtObe OvrwtObe.UT_US PNC PNC.LHD PreBir PreBir.UT_US SmoThiTriPre SmoThiTriPre.Year HealthStatus The following outcomes are related to preterm birth: *Health problems (including abnormal growth and infant death) *Costs associated with low birth weight births, premature births, and maternal and infant mortality and morbidity InfMort InfMort.Ut_USYear LBW LBW.Ut_USYear PreBir.Cnty by County, Utah, 2015-2019 and U.S., 2019 Percentage of Live Born Infants PreBir.Race by Mother's Race, Utah, 2019 Percentage of Live Born Infants PreBir.Eth by Mother's Ethnicity, Utah, 2019 Percentage of Live Born Infants PreBir.LHD by Local Health District, Utah and U.S., 2019 Percentage of Live Born Infants PreBir.SA by Utah Small Area, 2017-2019 and U.S., 2019 Percentage of Live Born Infants PreBir.UT_US Utah and U.S., 1997-2019 Percentage of Live Born Infants