Oregon boasts second-lowest rate for premature births

Oregon has the second-lowest rate of premature births in the nation, according to a "Premature Birth Report Card" from the March of Dimes.

But that earns Oregon only a C grade from the charity -- the same grade as Washington, which had the fifth-best rate.

One state got a B grade from the charity focused on pregnancy and baby health: Vermont, the only state where fewer than 1 in 10 babies are born prematurely.

The mediocre grades show how far the Northwest, and the whole country, are from a government goal to hold premature births below 7.6 percent of all deliveries by 2010, said Michelle Larsen, Oregon spokeswoman for March of Dimes.

The group reported that the premature birth rate is more than 20 percent higher today than in 1990.

Curbing early births could save the country billions of health care dollars and save thousands of babies from disability or death. Complications from premature birth are the main cause of death for infants younger than 1 month old, and babies who survive face brain damage, learning disabilities, blindness and other problems.

"The impact of each one of these, on the baby and on the family and on society, is huge," said Dr. Richard Lowensohn, an Oregon Health & Science University expert on pregnancy and newborn health.

The March of Dimes gave 23 states D's in the first of what it intends to make annual report cards. Washington, D.C., and 18 states flunked. So did Puerto Rico, the worst performer, where almost a fifth of babies are born before 36 weeks of the normally 40-week gestation.

The worst states largely sit in the South -- places such as Mississippi, Alabama and Louisiana, where many residents are African American, a group hit especially hard by premature births. Some of that disparity seems to stem from racial differences in education, income and access to health care. But biological factors, such as the amount of red cells in a mother's blood, also may play a factor.

The Northwest's whiteness "is a significant issue" contributing to its low rate of premature births, said Lowensohn, who volunteers with the March of Dimes. But it's not the only explanation -- members of all racial groups have lower rates of premature birth in Oregon than in Mississippi or Alabama, for instance.

Oregon's numbers also are helped by "a relatively good rate of prenatal care," Lowensohn said, and aggressive programs to improve nutrition for pregnant women, largely through statewide centers assisting low-income women.

Fertility clinics in Oregon are also more conservative about implanting multiple embryos in women seeking to get pregnant, he said. That lowers premature birth rates because twins, triplets and larger multiples are likely to be born early.

It will take more than good nutrition and prenatal care for the nation to hit its 2010 goal, Lowensohn said. But just what steps can cut the rate that low won't be clear until scientists better understand the causes for premature birth.

Lowensohn said it looks like "very premature" births -- before 32 weeks' gestation -- may stem from different causes than births between 32 and 36 weeks of age.

"Some of it may be infections. . . . Some of it may be genetic. Some of it may be nutritional," he said. "It's not a simple problem."

The government and groups including the March of Dimes are funding research to figure out why babies come too soon, but more money would help, especially from the government, Lowensohn said.

Andy Dworkin: 503-221-8271; andydworkin@news.oregonian.com