Health Indicator Report of Preterm Birth

Notes

Data for preterm births calculated by Maternal and Child Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in June 2020. Birth certificate data updated by HAVRS on June 26, 2020.   [SAS analysis in June 2020] Alaska links vital records to Medicaid/CHIP enrollment data records to determine enrollment of either parent or infant at the time of the birth.

Data Interpretation Issues

Gestational age is based upon obstetrical estimate (OE) defined as the best estimate of an infant's gestational age in completed weeks based on the clinician's final estimate of gestation.^1^ Starting in 2014, the National Center for Health Statistics moved to using the obstetric estimate of gestation at delivery (OE). All data are presented using the OE, unless noted otherwise.[[br]] [[br]] ---- {{class .SmallerFont 1. National Center for Health Statistics. Guide to completing the facility worksheets for the certificate of live birth and report of fetal death (2003 revision). 2019.[https://www.cdc.gov/nchs/data/dvs/GuidetoCompleteFacilityWks.pdf]. Accessed on June 30, 2020.}}

Definition

Preterm birth is the live birth of an infant before 37 weeks of gestation. The preterm birth rate is the number of live births that occurred before 37 weeks of gestation, divided by the total number of live births over the same time period.

Numerator

Number of live births that occurred before 37 weeks of gestation in the resident population for a specific time period.

Denominator

Total number of live births in the resident population for a specific time period.

Healthy People Objective: Total preterm births

U.S. Target: 9.4 percent

Other Objectives

March of Dimes goal for 2020: 8.1%

How Are We Doing?

In 2019, the rate of preterm births was 9.7%. Although the overall percentage of preterm births has been roughly stable for the past twenty years, a significant increase has occurred since 2012 when the preterm birth rate was 7.6%. There has also been a rapid increase in the preterm rate for Alaska Native births between 2016 (11.3%) and 2019 (13.5%). White persons continue to have the lowest overall preterm birth rate (7.6%) in 2019.

How Do We Compare With the U.S.?

The Alaska preterm birth rate has been slightly below the U.S. rate since 2007.^3^[[br]] [[br]] ---- {{class .SmallerFont 3. Hamilton BE, Martin JA, Osterman MJK. Births: Provisional data for 2019. Vital Statistics Rapid Release; no 8. Hyattsville, MD: National Center for Health Statistics. May 2020. [https://www.cdc.gov/nchs/data/nvsr/nvsr-8-508.pdf]. Accessed on June 30, 2020. }}

What Is Being Done?

The Alaska Department of Health and Social Services, Division of Public Health, Section of Women's, Children's, and Family Health (WCFH) serves as the administrative partner to the Alaska Perinatal Quality Collaborative (AKPQC). Established in January 2019, the AKPQC advances data-driven initiatives that improve maternal and newborn care in Alaska. With statewide membership and a steering committee comprised of health care professional organizations, hospital clinicians and leadership, and public health professionals, the AKPQC is well-positioned to promote standardized maternal care across Alaska health care facilities with a focus on reducing unnecessary risky procedures and treatments.^4^ Many states have active PQCs, and they have used them to contribute to improvements in perinatal outcomes and collectively address issues related to maternal and newborn health. PQC members identify health care processes that need to be improved and use the best available methods to make changes as quickly as possible.^5^ [[br]] [[br]] ---- {{class .SmallerFont 4. Alaska State Hospital and Nursing Home Association. Alaska Perinatal Quality Collaborative. 2020.[https://www.ashnha.com/alaska-perinatal-quality-collaborative/]. Accessed on June 30, 2020. 5. Center for Disease Control and Prevention. Perinatal Quality Collaboratives. 2020.[https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm]. Accessed on June 30, 2020.}}

Health Program Information

Alaska participated in the Collaborative Improvement and Innovation Network (CoIIN) to reduce infant mortality and improve birth outcomes. Through CoIIN, Alaska used evidence-based practices to focus on factors that may influence the rate of infants born preterm; such as smoking cessation (before, during and/or after pregnancy), safe sleep practices and preconception/interconception health. The fourth focus area was safe sleep, important for the health of infants who are born preterm. For more information on CoIIN: [https://www.nichq.org/project/collaborative-improvement-and-innovation-network-reduce-infant-mortality-infant-mortality] Accessed September 23, 2020.