WASHINGTON — Massachusetts and New Hampshire received passing grades on a "report card" on premature births released this week by the March of Dimes.
The goal of the first annual Premature Birth Report Card was to highlight state-by-state disparities and track progress toward meeting a federal goal of lowering preterm births.
If the "D" grade charity bestowed on the nation is any indication, there's not much chance of meeting that goal by the original 2010 deadline.
Not a single state received an "A," and the only state to earn a "B" was Vermont. New Hampshire was one of eight states that earned a "C," while Massachusetts was one of 23 to receive a "D". Eighteen states plus Puerto Rico and the District of Columbia got failing grades of "F."
More than half a million U.S. babies — one in every eight — are born premature each year, a toll that's risen steadily for two decades. The government's goal: No more than 7.6 percent of babies born before completion of the 37th week of pregnancy.
Preterm birth can affect any mother-to-be, stressed a recent U.S. Surgeon General's meeting on the problem. Scientists don't understand all the complex causes.
But this week's report highlights big geographic differences that March of Dimes President Dr. Jennifer Howse called "a dash of cold water.
"It is unacceptable that our nation is failing so many preterm babies," she said. "We are determined to find and implement solutions to prevent preterm birth, based on research, best clinical practices and improved education for moms."
Preterm birth is the leading cause of death in the first month of life in the United States. The preterm birth rate has increased about 20 percent since 1990, and costs the nation more than $26 billion a year, according to an Institute of Medicine report issued in July 2006.
Babies who survive a premature birth face the risk of serious lifelong health problems including learning disabilities, cerebral palsy, blindness, hearing loss, and other chronic conditions including asthma.
In Vermont, 9 percent of babies were preemies in 2005, the latest available data. In New Hampshire, 10.5 percent of babies were premature, compared to 11.3 percent in Massachusetts.
Travel south, and prematurity steadily worsens: In West Virginia, 14.4 percent of babies were preemies; more than 15 percent in Kentucky and South Carolina; more than 16 percent in Alabama and Louisiana; and a high of 18.8 percent in Mississippi.
The report urges states to address three factors that play a role:
Lack of insurance, which translates into missed or late prenatal care. In states with the highest prematurity rates, at least one in five women of childbearing age are uninsured. Early prenatal care can identify risks for preterm labor and sometimes lower them.
Smoking increases the risks of prematurity, low birth weight and birth defects. Government figures suggest 17 percent of women smoke during pregnancy. The new report urged targeting smoking by all women of childbearing age. About a third of those women smoke in Louisiana and West Virginia, the report says, compared with 9.3 percent and 11 percent in Utah and California, respectively.
Then there's the trickier issue of so-called late preemies, babies born between 34 and 37 weeks. They're fueling the nation's prematurity rise. While not as devastating as a baby born months early, being even a few weeks early can cause learning or behavioral delays and other problems. And recent research suggests at least some near-term babies are due to Caesarean sections scheduled before full-term, either deliberately or because of confusion about the fetus's exact age.
Howse urged hospitals to double-check that women given an early C-section truly need one for a medical problem, as current health guidelines recommend.
