Premature births in California have reached new lows, but the Valley's numbers -- while improving -- lag behind the rest of the state, according to a March of Dimes study released Friday.
At 9.6% of all births occurring before full term, California was one of five states with an "A" grade. With the state representing 12% of the nation's births, that's a substantial achievement, said Leslie Kowalewski, associate state director for the March of Dimes' California chapter.The March of Dimes defines a premature birth as one occurring before 37 weeks into a pregnancy.
The March of Dimes examined three areas for improvement -- having more women insured, reducing late preterm births that are not health related and reducing the number of smokers.
More women are expected to be insured under the Affordable Care Act, and the number of smokers is expected to fall, too.
But a major focus been on getting doctors to reduce medically unnecessary preterm births.
Kowalewski said children born between 39 and 40 weeks have fewer lung issues, and better brain and organ development. They also feed, sleep and bond better.
"We want to get doctors to rethink what they are doing," she said. "It makes a difference in the health of these babies."
Fresno County's premature birth rate was second highest in California in 2011 and 2012, March of Dimes officials say. In the Central Valley, no county was under 10%, according to final 2011 figures.
Preliminary data for 2012 indicated that Fresno County's preterm birth rate was 11.5%, down from 12.3% in 2011.
Fresno County officials are researching causes of the high rate, said Rose Mary Garrone, manager for public health nursing.
She said county officials want to know whether the problem is endemic to the Valley, if it's health related in individuals, a neighborhood or certain populations.
She said difficult access to medical facilities and insurance sometimes keeps women from getting prenatal care, but "we are very optimistic that with the Affordable Care Act and Medicaid expansion, it will improve."
Fresno County's 11.5% rate equaled the national rate, which was a "C" grade from the March of Dimes.
The national rate increased more than 35 percent between 1981 and 2006, peaking at 12.8 percent.
And California has reduced its preterm birth rates to its lowest levels since the inception of March of Dimes studies more than 30 years ago. California peaked at 10.9% in 2007.
The March of Dimes has worked with hospitals to eliminate inducing labor and C-sections scheduled weeks ahead of a due date unless they are medically necessary. Much of the recent U.S. improvement comes from reducing elective early deliveries -- 37 weeks or earlier -- leading to a drop in "late preemies," March of Dimes officials say.
The March of Dimes estimates that reducing the number of premature births in recent years has saved about $9 billion in health and other costs.
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