Georgia Gets Another ‘F’ On Preterm Births

Georgia has earned an “F’’ grade for its rising rate of preterm births, according to a newly released report.

The 2020 March of Dimes Report Card, released this week, said the state’s rate of preterm births, often called premature births, climbed to 11.7 percent in 2019, continuing a steady climb from a bottom of 10.7 percent in 2013.

It’s the second straight year that Georgia has received a failing grade in the report.

For the fifth year in a row, the U.S. preterm birth rate increased, reaching to 10.2 percent of births, earning the nation a “C-” grade in this year’s report, compared to last year’s “C.”

Preterm birth rates have worsened in 39 states and Washington, D.C., the report noted.

Nationally, more than 30,000 babies every month are born preterm, before 37 weeks of pregnancy have elapsed. 

Being born too early is the largest contributor to infant death. And babies who survive an early birth often face serious and lifelong health problems, including breathing problems, vision loss, cerebral palsy and intellectual delays.

Black women in Georgia and nationally have higher percentages of preterm births, the March of Dimes report shows.

Nationally, women of color are up to 50 percent more likely to give birth preterm, and their children face up to a 130 percent higher infant death rate. Disparities in preterm birth rates have increased over the past several years in the United States, the March of Dimes report said.

In Georgia, African-American women had the highest rates of infant mortality at 11.1 per 1,000 live births, while the statewide rate for all races actually declined to 7.1.

“Although there has been some incremental progress in advancing policies that will address better maternal and infant health care, this progress is not happening quick enough, and is tempered by increasing racial/ethnic health care disparities in preterm birth,” Stacey Stewart, president and CEO of March of Dimes, said in a statement.

Factors causing preterm births include a lack of health insurance. The report found that nearly 20 percent of Georgia women aged 15-44 are uninsured, and 15.2 percent of women in that age category live in poverty.

Another major factor is limited access to supportive care before, during and after pregnancy.

Mothers with various conditions such as hypertension, preeclampsia, incompetent cervix (weakness of cervical tissues), and multiple gestation are at increased risk of delivering preterm and low-birthweight infants, said Merrilee Gober, an obstetrical nurse, attorney and a principal of Georgia Health Advocates.

“Prenatal care allows for the diagnosis and management of these conditions and many other conditions that can affect the long-term health of both mother and baby, thereby significantly reducing the risk of low-birthweight, especially very low-birthweight, babies,’’ Gober said.

She said that in Georgia, 2,034 of 146,464 births (1.38 percent) did not have prenatal care in 2008. Ten years later, that number was 5,051 of 126,051 births (4 percent), meaning the rate has nearly tripled here in 10 years and is more than double the national rate of 1.8 percent.

Southern figures particularly bad

Seven other states, all in the South or on its periphery, also received an “F’’ grade in the new March of Dimes report: Alabama, Arkansas,  Louisiana, Mississippi, Oklahoma, South Carolina and West Virginia.

Six Georgia counties received grades for their preterm birth rates in the report. The highest grades were for Cobb and DeKalb counties, in metro Atlanta, with a ‘‘D+’’ for each.  Among other metro Atlanta counties, Gwinnett received a “D,’’ and Fulton and Clayton counties were graded “F.’’

The city of Atlanta itself received a “D-” grade.

On the coast, Chatham County, home of Savannah,  rated an “F.’’

If a woman has had a preterm birth, she stands an increased chance of having another. Intervals between pregnancies also make a difference. Georgia mothers who have less than one year of spacing between delivery and the next pregnancy have a higher preterm birth rate.

In addition, access to obstetrical care is a problem in much of Georgia. Longer distances to birthing hospitals can increase chances for preterm birth, but just 59 of the state’s 159 counties have labor and delivery units, and only about 75 hospitals in the state routinely deliver babies, the Georgia OBGyn Society said in 2018.

Polly McKinney of advocacy group Voices for Georgia’s Children added Thursday that “parental health often affects infant health.”

She said that Georgia’s current effort to lengthen Medicaid coverage for mothers’ postpartum care from two months to six months, and a growing awareness of the disproportionate outcomes for black mothers and infants, will hopefully  succeed “not only in improving Georgia’s grade, but most importantly in saving the lives of our mothers.”