April 18, 2024

Reducing Preterm Birth Rates Benefits Everyone

Ken Levey, MD, MPH, Chief Executive Officer Mother Goose Health

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Preterm birth rates in the U.S. continue to march higher in spite of efforts by both public and private entities. This represents a continued and disastrous trend. According to the CDC, just 57.11% of babies were born full term in 2022 compared to 60.76% in 2014, representing a consistent year-over-year decline.[1] During the same period, preterm births (babies born less than 37 weeks into pregnancy) and early births(babies born at 37 to 38 weeks of pregnancy) increased by 12% and 20%,respectively.[2]

Today, the U.S. has the highest preterm birth rate among all wealthy nations; 10.4% of all births.[3]While much of the focus has been on Black pregnancies, the problem encompasses all races and ethnicities. Between 2014 to 2022, preterm birth rates rose 11%for Black mothers, 11% for White mothers, and 13% for Hispanic mothers.[4]  

Regardless of race and ethnicity, the U.S. has become the most dangerous place to have a baby among all wealthy nations.[5] And our lead in this problematic category continues to widen.

Cause and effect

One of the primary reasons for preterm births is a lack of properly oriented prenatal care. This is often driven by the absence of connected systems, poverty and lack of health insurance. Just 36% of women without insurance receive prenatal care compared to 84% with insurance, and nearly 48%of women without insurance are also low income.[1] The U.S. Office on Women’s Health reports that a lack of prenatal care increases a baby’s likelihood of dying during infancy by five times compared to those whose moms received early prenatal care.[1] Comprehensive care during the first 12 weeks of pregnancy is especially critical to identifying and proactively addressing issues that could lead to preterm births and infant mortality.

Evidence demonstrates that preterm infants are at the highest risk of morbidity and mortality and are more likely to experience developmental disabilities in the areas of learning, communication, self-care, socialization, and physical development.[2],[3] According to the March of Dimes, other conditions associated with preterm birth include cerebral palsy, behavioral problems, mental health conditions, neurological disorders, asthma, dental problems, hearing loss, infections, intestinal disorders, and vision problems.[4]

Even beyond childhood, preterm babies are more likely to experience poor health and premature aging as adults.[5]In other words, preterm births set up a lifelong path of challenges that can impact not just individuals, but families, communities, and entire populations for generations to come. The economic impact is substantial as well, estimated to be $25.2 billion annually, broken down as “$17.1 billion for medical care of persons born preterm, $2.0 billion for delivery care, $1.3billion for early intervention and special education, and $4.8 billion in lost productivity due to associated disabilities in adults.”[6]

Time for a new approach

One of the best ways to prevent preterm births is by leveraging predictive risk modeling to identify high-risk pregnancies early, enabling providers to address issues proactively. This is the model used by Mother Goose Health, a leading integrated platform that aligns incentives and delivers value-based care to obstetrics through evidence-based clinical models. Unifying communication and care, the platform facilitates rapid clinical interventions to reduce the likelihood of preterm birth, NICU stays, and other complications.

In a recent case-control study the preterm birth rate amongst mother’s utilizing Mother Goose Health’s unified maternity care platform was 4.68%compared to a rate of 8.76% for those not using the platform; a total reduction of 53% in preterm birth rates across all races and ethnicities.

Further research by Mother Goose Health also shows a 22%reduction in live cesarean delivery rates compared to the national average of32.1%[1] and an 18% increase in post partum visit attendance rate versus the national average of 72.1%.[2]

Mother Goose Health coordinates all elements of maternal healthcare from pregnancy to a year postpartum and patients benefit by receiving a mobile app to help them stay on track with their care plans. The app also provides patient-specific educational resources, 24/7 in-app chat, easy-to-use self-monitoring tools, live support from mental health providers, appointment reminders, and access to a care management support team, to help them better navigate their health and the health of their babies throughout the pregnancy and beyond.

Providers benefit from bi-directional EHR and automated workflows, as well as closed-loop referrals and support from a dedicated care management team for more effective, coordinated, and comprehensive care. Proactive alerts quickly inform providers when rising risk is detected, with customizable emergency alert pathways, and providers can enhance patient experiences and achieve compliance within a value-based care model.

Payors also benefit through better outcomes and the reduction in costs associated with earlier risk detection for timely interventions, evidence-based care pathways and cross-continuum integration. By improving the utilization of high-quality network providers and services, Mother Goose Health enhances payor member engagement and satisfaction.

The journey forward

The rising numbers of preterm births should serve as a beacon to healthcare leaders that it’s time to take a new approach. Without addressing this troubling trend, moms, babies, communities, and the population at large will continue to suffer the consequences. But they don’t have to. By partnering with Mother Goose Health, providers and patients receive the support they need to change the healthcare trajectory for generations to come.

[1] https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-01.pdf

[2] https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-01.pdf

[3] https://www.marchofdimes.org/report-card

[4] https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-01.pdf

[5] https://www.pbs.org/newshour/health/u-s-maternal-deaths-more-than-doubled-over-20-years-heres-who-fared-the-worst#:~:text=Among%20wealthy%20nations%2C%20the%20U.S.,disease%2C%20suicide%20and%20drug%20overdose.

[6] https://www.forbes.com/sites/williamhaseltine/2024/02/22/shorter-lives-for-new-mothers-and-neonates-prenatal-and-postnatal-care-inequities/?sh=765e6c5017b8

[7] https://www.forbes.com/sites/williamhaseltine/2024/02/22/shorter-lives-for-new-mothers-and-neonates-prenatal-and-postnatal-care-inequities/?sh=765e6c5017b8

[8] https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-01.pdf

[9 ] https://www.marchofdimes.org/find-support/topics/birth/long-term-health-effects-preterm-birth#:~:text=Preterm%20birth%20can%20lead%20to,Physical%20development

[10] https://www.marchofdimes.org/find-support/topics/birth/long-term-health-effects-preterm-birth#:~:text=Preterm%20birth%20can%20lead%20to,Physical%20development

[11] https://www.forbes.com/sites/williamhaseltine/2024/02/22/shorter-lives-for-new-mothers-and-neonates-prenatal-and-postnatal-care-inequities/?sh=765e6c5017b8

[12] https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwinku6t7tCEAxWwv4kEHV15CtAQFnoECA4QAw&url=https%3A%2F%2Fstacks.cdc.gov%2Fview%2Fcdc%2F133860%2Fcdc_133860_DS1.pdf&usg=AOvVaw1h0sLFgepBlJbo2FxIYbCQ&opi=89978449

[13] https://www.marchofdimes.org/peristats/data?reg=99&top=8&stop=86&lev=1&slev=1&obj=9&dv=ms

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283204/#:~:text=Results%3A,with%20a%20mean%20of%2072.1%25