Minnesota and a dozen other states earned their first "B" grades from the March of Dimes for their success in reducing pre-term births -- a major public health problem that increases the number of infant deaths, disabilities and learning and developmental problems.

Pre-term births (births prior to 37 weeks gestation) had been increasing for decades in the U.S. until 2006. Since then, the rate in Minnesota has declined gradually from 10.5 percent to 10.1 percent, according to the March of Dimes report released today.

Only Vermont had earned a "B" grade before, with many states earning D and F grades. The progress is a little deceptive. Until this year, most states were graded based on whether their pre-term birth rates were close to the 2010 Healthy People goal of less than 7.6 percent. No states even came close, so the March of Dimes' new 2020 target is much less challenging -- 9.6 percent. Better grades are now easier to earn.   

Even so, the progress in the U.S. in reducing pre-term births is both real and historic. Marianne Keuhn, state director of programs for the Minnesota chapter of March of Dimes, said the reduction in pre-term births has come through several changes:

  1. Fewer pregnant women are smoking. The rate in Minnesota has dropped from 18.8% to 16.9%. 
  2. Doctors are treating infections in pregnant women more aggressively thanks to research showing how even common periodontal infections can increase the chances of giving birth pre-term.
  3. Improved infertility treatments have reduced the number of women using multiple embryos for IVF procedures and giving birth to twins, triplets or more. (Multiple births are often pre-term.)
  4. Increased use of the hormone drug progesterone to reduce the risk of pre-term birth in pregnant women.
  5. Hospitals and health plans have cut the number of elective inductions or C-sections that take place prior to 39 weeks gestation. (A new state policy on this takes effect in January.)

Research showed that hospitals were conducting many more elective inductions and C-sections prior to 37 weeks gestation than hospital officials had thought, Keuhn said. As additional research showed the harm this could cause to the babies, the practice has been curtailed.

The public is more aware of the risks of early inductions and C-sections as well as the consequences of aggressive fertility treatments, Keuhn added.  "I hate using the example of the Octomom, but as unfortunate as that situation was, it really brought to a head that these (problems) need to get addressed."

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