A new study published in the Journal of the American Medicine Association Open Network examines the conditions and trends that are contributing to an alarming increase in preterm birth in the US.
The research noted an overall 10.6% increase for all populations in preterm birth in California over the past decade. Funded in part by the California Preterm Birth Initiative (PTBi), it also found increased risk based on racial and ethnic group and insurance type. Additionally, conditions such as preexisting diabetes, sexually transmitted infections, and mental health issues have more than doubled the risk among expectant mothers.
Individuals who identified as American Indian or Alaska Native, or Black consistently experienced the highest preterm birth rates, especially those with public health insurance. The risk for white individuals with private health insurance is 5.8%, but Black and American Indian or Alaska Native people with public health insurance were at 11.3% and 10.3%, respectively.
The research, led by Laura L. Jelliffe-Pawlowski, a professor at UCSF and NYU, and affiliated Senior Faculty with the UCSF PTBi, and Karen Tabb Dina, a professor at the University of Illinois Urbana-Champaign in the School of Social Work and at the Beckman Institute for Advanced Science and Technology, utilized data from more than 5.4 million births between 2011 to 2022 in California.
The study also found that other factors increased the risk of preterm birth including housing insecurity, inadequate access to quality prenatal care, and exposure to systemic racism. Jelliffe-Pawlowski, Tabb Dina, and colleagues also found that Black individuals born outside the U.S. had lower PTB rates compared to their US-born counterparts, demonstrating the harmful effects of systemic racism on maternal health.
The research also found protective effects of certain programs. For example, participation in programs designed to support pregnant women, such as the Women, Infants, and Children (WIC) program resulted in healthier outcomes for both the pregnant individual and child. WIC offers nutritional education, food and formula vouchers, breastfeeding support, health care, and social services.
While participation in public health insurance, like Medi-Cal, California's Medicaid program, increased preterm birth for all people, the study noted the potential impact of a new program by the Centers for Medicare & Medicaid Services. Transforming Maternal Health Model helps state Medicare programs to provide physical, mental, and social needs, including housing, to reduce disparities in access and treatment. It addresses a majority of the factors associated with increasing rates of preterm birth
The rising rates of preterm births in California highlight a pressing public health issue that disproportionately affects marginalized communities. This research suggests that implementing more programs that focus on medical care and the social factors that affect pregnant people may contribute to a healthier future for all families.
