by Amanda Conschafter, blog editor
Prematurity Awareness Month kicked off this November with a “C” grade for the United States from the 2015 March of Dimes Premature Birth Report Card. The United States is among the lowest-ranking “high-resource” countries. Racial, ethnic and geographic disparities continue to characterize prematurity, the March of Dimes reveals. And the report card’s release coincides with the onset of a viral season that compounds these disparities—respiratory syncytial virus, or RSV, season.
City-specific grades, a first for the annual March of Dimes report card, emphasized existing disparities. Portland received an “A” grade for its preterm birth rate of 7.2 percent, while Shreveport, Louisiana earned an “F” for its preterm birth rate of 18.8 percent. Maine displayed the most minor gap among racial and ethnic groups; the District of Columbia, the most egregious.
Though the report card highlights only the incidence of prematurity, these disparities can persist after birth. RSV is a prime example. African American babies, more likely to be born prematurely, often bear the brunt of the deadly seasonal virus. Complications can result in re-hospitalization, ventilator support and bouts of wheezing. It accounts for 90,000 hospitalizations and 4,500 deaths per year in children 5 years of age and younger.
Families of preemies vulnerable to RSV face limited options; no vaccine exists. Preventative treatment, palivizumab, is FDA approved for protecting infants born at up to 35 weeks gestation, and was pediatric health care providers’ go-to treatment for years. But in 2014 the American Academy of Pediatrics Committee on Infectious Diseases issued new—and newly restrictive—guidelines advocating use only for infants born at 29 weeks gestation or earlier.
First-year feedback confirmed parents and preemie advocates’ fears; data from 43 U.S. hospitals found 709 hospitalized infants whose gestational age ranged from 29 to 35 weeks. Now preemie health care providers and preemie families prepare to face the second RSV season under restricted access to palivizumab.
Granted, the outlook for preemies isn’t all bleak. Though still low among developed countries, the United States managed to meet its March of Dimes 2020 goal for reducing the prevalence of prematurity early. The organization has now issued a new goal, reducing premature live births to 8.1 percent by 2020.
But for pre-term infants born after 29 weeks, November marks an ironic milepost. At the same time that advocates and policymakers are reflecting on the incidence of prematurity across the nation, many preemies prepare to face a deadly viral season unprotected.