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 November 2018. Birth certificate data updated by HAVRS on September 14, 2018.   [SAS analysis in November 2018] Alaska links vital records to Medicaid/CHIP enrollment data records to determine enrollment of the mother, father, 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). 2016.[https://www.cdc.gov/nchs/data/dvs/GuidetoCompleteFacilityWks.pdf]. Accessed on November 1, 2018.}}

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 2017, the rate of preterm births was 9.0%. Since 2007, the overall percentage of preterm births has remained roughly stable, ranging between 7.6 (in 2012) and 9.0 (in 2017). White mothers continue to have the lowest overall preterm birth rate (7.3% in 2017), while Black mothers and Alaska Native/American Indian mothers have the highest rates (12.2% and 11.5%, respectively, in 2017).

How Do We Compare With the U.S.?

The Alaska preterm birth rate has been slightly below the U.S. rate since 2006.^3^[[br]] [[br]] ---- {{class .SmallerFont 3. Hamilton BE, Martin JA, Osterman MJK, Driscoll AK, Rossen LM. Births: Provisional data for 2017. Vital Statistics Rapid Release; no 4. Hyattsville, MD: National Center for Health Statistics. May 2018.[https://www.cdc.gov/nchs/data/vsrr/report004.pdf]. Accessed on November 1, 2018. }}

What Is Being Done?

Alaska will be launching a Perinatal Quality Collaborative (PQC) in January 2019 to bring together birthing facilities, health care providers and public health entities to identify ways to improve the quality of care for mothers and babies in Alaska.^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. 2018.[https://www.ashnha.com/alaska-perinatal-quality-collaborative/]. Accessed on November 5, 2018. 5. Center for Disease Control and Prevention. Perinatal Quality Collaboratives. 2018.[https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm]. Accessed on November 5, 2018.}}

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 Apr 26, 2018.