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Complete Health Indicator Report of Preterm Birth

Definition

The number of live births under 37 weeks gestation divided by the total number of live births over the same time period.

Numerator

Number of live born infants born less than 37 weeks gestation.

Denominator

Total number of live births.

Data Interpretation Issues

Reporting of preterm birth (PTB) trends has been complicated by a change in how gestational age (GA) is reported by the National Center for Health Statistics. PTB is defined as a birth less than 37 weeks gestation. Historically, GA was calculated by the mother's last menstrual period (LMP) and PTB rates were reported this way. Since the 2003 revision of the birth certificate, GA is also reported by obstetric estimate (OE), which is considered more accurate. Beginning in 2010, national rates are reported using OE and are not consistent with rates reported before 2010. Utah rates have been reported using OE since 1996.

Why Is This Important?

Preterm birth, birth before 37 weeks gestation, is the leading cause of perinatal death in otherwise normal newborns and is a leading cause of long-term neurological disabilities in children. Infants born before 32 weeks gestation bear the biggest burden representing more than 50 percent of infant deaths. Babies born preterm also have increased risks for long term morbidities and often require intensive care after birth. Health care costs and length of hospital stay are higher for premature infants. For a preterm infant without complications, average hospital stays are three times longer than a term infant, and for a preterm infant with complications, average hospital stays are over seven times longer than a term infant. Utah inpatient hospital discharge data (2016) indicate that average hospital charges for a premature infant was $73,498 (DRG 790, 791, 792) compared to $3,283 for a normal newborn infant (DRG 795). Utah inpatient hospital discharge data (2016) indicate that average length of stay for a premature infant was 16 days (DRG 790, 791, 792) compared to 1.8 days for a normal newborn infant (DRG 795).

Healthy People Objective MICH-9.1:

Reduce total preterm births
U.S. Target: 9.4 percent
State Target: 8.9 percent

How Are We Doing?

Utah's preterm birth rate increased from 8.8% in 1990 to a high of 10.1% in 2005. The rate has remained under 10% from 2006 to 2017. The Utah preterm birth rate decreased to 9.4% in 2017.

How Do We Compare With the U.S.?

The U.S. preterm birth rate was 9.9% in 2017. In 2010, the U.S. began reporting preterm birth rates based on obstetric estimates rather than based on last menstrual period (LMP) making it difficult to compare Utah to the U.S. farther back than 2010. The obstetric estimate has been shown to more accurately reflect the true gestational age of the infant than LMP.

What Is Being Done?

Approximately half of preterm births in Utah are due to complications of the pregnancy (multiple births, placental problems, fetal distress, infections) or maternal health factors such as high blood pressure or uterine malformations. The remaining preterm births have unexplained causes. In an effort to reduce the preterm birth rate, emphasis is being placed on maternal preconception health to help women achieve optimal health prior to pregnancy. Some ways women can achieve optimal health include stopping use of tobacco and alcohol, controlling chronic diseases such as diabetes and high blood pressure under control, and obtaining an optimal pre-pregnancy weight. Early and continuous prenatal care is encouraged to detect problems that may arise during pregnancy. Women should be educated regarding the danger signs of pregnancy and the importance of recognition and treatment for these symptoms. Standards for assisted reproductive technology should be followed to reduce the frequency of twins or higher order multiple pregnancies. Pregnant women should also be referred for appropriate services such as Women, Infant and Children (WIC) and psychosocial counseling. Studies have demonstrated a substantial reduction in the rate of recurrent preterm birth in women receiving progesterone supplementation. Pregnant women who have had a previous spontaneous preterm birth, particularly in the immediately preceding pregnancy, should be offered progesterone supplement beginning at 16-20 weeks gestation. Women pregnant with twins or triplets may not benefit from this medication. The maternal committee of the Utah Women and Newborns Quality Collaborative (UWNQC) ([http://uwnqc.org/]) has identified optimization of 17 alpha hydroxyprogesteronecaproate (17P) use to prevent recurrent spontaneous preterm birth (SPTB) in women with a previous history of SPTB as the primary focus of their efforts. This group has developed a series of videos on preterm birth prevention and is working to educate providers on the use of 17P. The committee has produced matarials to help educate families who have delivered prematurely on what they can do to reduce the chances of preterm birth from happening in future pregnancies. In addition, the maternal committee has worked on access to immediate postpartum long-acting reversible contraception as well as other family planning access.

Evidence-based Practices

Use of 17P (progesterone) in the first trimester of pregnancy for women who have had a previous preterm birth.

Available Services

'''Utah Women and Newborn Quality Collaborative:''' [http://uwnqc.org][[br]] Provider and patient education about improving maternal and neonatal outcomes through collaborative efforts centered on quality improvement methodology and data sharing. '''The Power Your Life website:''' [http://www.poweryourlife.org][[br]] Public education about how to be at optimal health prior to pregnancy.[[br]] [[br]] Social media for Power Your Life include: *Facebook: [http://www.facebook.com/poweryourlifeutah] *Twitter: @Poweryourlife2 *Pinterest: [http://www.pinterest.com/poweryourlifeut][[br]] [[br]] '''Utah Tobacco Quit Line:''' 1-888-567-8788 '''Baby Your Baby Hotline:''' 1-800-826-9662[[br]] A public resource to answer pregnancy related questions and locate services. '''MotherToBaby:'''[[br]] Phone - 1-800-822-2229[[br]] Text - 1-855-999-3525[[br]] Email - expertinfo@mothertobaby.org[[br]] Live Chat- [http://www.mothertobaby.org][[br]] A service to answer questions about what's safe during pregnancy and breastfeeding.[[br]] [[br]] Social media for MotherToBaby include: *Facebook: [http://www.facebook.com/MotherToBaby] *Twitter: @MotherToBaby *Pinterest: [http://www.pinterest.com/MotherToBaby][[br]] [[br]] '''Baby Watch Early Intervention Hotline:''' 1-800-961-4226[[br]] Utah's network of services for children, birth to three years of age, with developmental delay or disabilities. '''March of Dimes, Utah Chapter:''' [http://www.marchofdimes.org/utah][[br]] The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality.[[br]] *Facebook: [https://www.facebook.com/marchofdimes][[br]] *Twitter: @MarchofDimes[[br]] *YouTube: [https://www.youtube.com/marchofdimes][[br]] [[br]] '''University of Utah Health Care Parent-to-Parent Support Group:''' 1-801-581-2098[[br]] Support Program for families of high risk/critically ill newborns.


Related Indicators

Relevant Population Characteristics

2017 data show the following population subgroups at higher risk of having a preterm birth: *Race (Utah mothers who were Asian or Native Hawaiian or Other Pacific Islander) *Maternal age (mothers older than 35) *Low educational attainment (high school diploma or less) *Being unmarried

Related Relevant Population Characteristics Indicators:


Health Care System Factors

2017 data show the following health care system factors contribute to a higher risk of having a preterm infant: *Access to prenatal care

Related Health Care System Factors Indicators:


Risk Factors

2017 data show the following risk factors contribute to having a preterm birth: *Previous preterm births *Pre-pregnancy BMI (obese prior to pregnancy) *Intervals less than 6 months between pregnancies or > 48 months *Multiple gestation (e.g. twins) *Tobacco use during pregnancy *Maternal chronic disease, such as hypertension or diabetes

Related Risk Factors Indicators:


Health Status Outcomes

The following outcomes are related to preterm birth: *Health problems (including abnormal growth and infant death) *Costs associated with low birth weight births, premature births, and maternal and infant mortality and morbidity

Related Health Status Outcomes Indicators:




Graphical Data Views

Preterm Births (Less Than 37 Weeks Gestation) by County, Utah, 2015-2017 and U.S., 2017

::chart - missing::
confidence limits

CountyPercentage of Live Born InfantsLower LimitUpper LimitNote
Record Count: 31
Beaver9.8%6.9%13.8%
Box Elder9.5%8.4%10.7%
Cache9.0%8.4%9.7%
Carbon10.3%8.2%12.8%
Daggett****
Davis9.7%9.3%10.2%
Duchesne8.8%7.3%10.7%
Emery9.1%6.5%12.7%
Garfield9.9%6.1%15.7%
Grand6.5%4.3%9.8%
Iron10.9%9.7%12.2%
Juab9.4%7.2%12.1%
Kane7.5%4.7%11.6%
Millard10.5%8.3%13.3%
Morgan10.1%7.6%13.1%
Piute12.9%4.6%31.1%*
Rich8.2%3.9%16.0%*
Salt Lake9.4%9.2%9.7%
San Juan9.6%7.6%12.2%
Sanpete11.3%9.6%13.3%
Sevier12.0%10.0%14.3%
Summit9.4%7.9%11.1%
Tooele10.8%9.8%12.0%
Uintah9.5%8.2%11.0%
Utah9.1%8.8%9.4%
Wasatch8.4%7.0%10.0%
Washington8.9%8.2%9.6%
Wayne7.4%3.3%15.2%*
Weber10.0%9.4%10.5%
State9.4%9.3%9.6%
U.S.9.9%2017 final

Data Notes

Note: County represents county of mother's residence. * Use caution in interpreting rates for Piute, Rich, and Wayne counties, the estimates have a coefficient of variation >30% and are therefore deemed unreliable by Utah Department of Health standards. ** The estimates for Daggett county have been suppressed because 1) the relative standard error is greater than 50% or the relative standard error can't be determined or 2) the observed number of events is very small and not appropriate for publication. 2017 U.S. data is final. Preterm birth is calculated by obstetric estimate.

Data Sources

  • Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Preterm Births (Less Than 37 Weeks Gestation) by Mother's Race, Utah, 2017

::chart - missing::
confidence limits

RacePercentage of Live Born InfantsLower LimitUpper LimitNote
Record Count: 7
American Indian/Native Alaskan10.7%8.3%13.6%
Asian12.0%10.2%13.9%
Black10.9%8.9%13.3%
Pacific Islander12.9%10.0%16.5%
White9.2%9.0%9.5%
All Races9.4%9.2%9.7%
U.S.9.9%2017 final

Data Notes

2017 U.S. data is final.[[br]] Preterm birth is calculated by obstetric estimate.

Data Sources

  • Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Preterm Births (Less Than 37 Weeks Gestation) by Mother's Ethnicity, Utah, 2017

::chart - missing::
confidence limits

Hispanic EthnicityPercentage of Live Born InfantsLower LimitUpper LimitNote
Record Count: 5
Hispanic9.8%9.1%10.4%
Non-Hispanic9.3%9.1%9.6%
Unknown Ethnicity11.3%9.0%13.3%
All Utahns9.4%9.2%9.7%
U.S.9.9%final

Data Notes

2017 U.S. data is final. Preterm birth is calculated by obstetric estimate.

Data Sources

  • Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Preterm Births (Less Than 37 Weeks Gestation) by Local Health District, Utah and U.S., 2017

::chart - missing::
confidence limits

Local Health DistrictPercentage of Live Born InfantsLower LimitUpper LimitNote
Record Count: 15
Bear River9.1%8.1%10.2%
Central10.2%8.5%12.1%
Davis County10.1%9.3%11.0%
Salt Lake County9.5%9.1%10.0%
San Juan10.6%6.8%16.2%
Southeast10.2%7.6%13.6%
Southwest9.1%8.1%10.1%
Summit9.0%6.6%12.3%
Tooele9.8%8.0%11.8%
TriCounty9.2%7.4%11.4%
Utah County9.0%8.5%9.6%
Wasatch8.7%6.3%11.8%
Weber-Morgan9.6%8.7%10.6%
State of Utah9.4%9.2%9.7%
U.S.9.9%final

Data Notes

Note: Local health district represents district of mother's residence. 2017 U.S. data is final. Preterm birth is calculated by obstetric estimate.

Data Sources

  • Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Preterm Births (Less Than 37 Weeks Gestation) by Utah Small Area, 2015-2017 and U.S. 2017

::chart - missing::
confidence limits

Utah Small AreasPercentage of Live Born InfantsLower LimitUpper LimitNote
Record Count: 131
Brigham City9.1%7.5%10.9%
Box Elder Co (Other) V29.3%7.0%12.3%
Tremonton9.6%7.8%11.8%
Logan V29.4%8.4%10.5%
North Logan7.6%6.3%9.1%
Cache (Other)/Rich (All) V210.6%8.9%12.7%
Hyrum9.4%6.9%12.5%
Smithfield7.8%6.0%10.0%
Ben Lomond9.8%8.8%11.0%
Weber County (East)8.2%6.8%9.7%
Morgan County10.0%7.6%13.2%
Ogden (Downtown)11.6%10.2%13.1%
South Ogden10.1%8.8%11.6%
Roy/Hooper10.2%9.0%11.6%
Riverdale9.1%7.6%10.9%
Clearfield Area/Hooper10.8%9.8%11.8%
Layton/South Weber9.0%8.1%9.9%
Kaysville/Fruit Heights10.2%8.8%11.8%
Syracuse11.1%9.4%13.0%
Centerville9.4%7.4%11.8%
Farmington8.5%6.9%10.3%
North Salt Lake10.0%8.4%11.8%
Woods Cross/West Bountiful8.9%7.1%11.1%
Bountiful8.9%7.8%10.1%
SLC (Rose Park)8.7%7.5%10.1%
SLC (Avenues)8.8%6.7%11.3%
SLC (Foothill/East Bench)8.2%6.6%10.3%
Magna11.1%9.5%12.9%
SLC (Glendale) V210.0%8.5%11.8%
West Valley (Center)10.5%9.4%11.7%
West Valley (West) V210.8%9.3%12.6%
West Valley (East) V29.3%8.2%10.4%
SLC (Downtown) V29.9%8.2%11.8%
SLC (Southeast Liberty)8.6%6.8%10.8%
South Salt Lake9.7%8.2%11.4%
SLC (Sugar House)7.2%6.0%8.7%
Millcreek (South)9.1%7.3%11.4%
Millcreek (East)8.3%6.7%10.2%
Holladay V27.6%6.1%9.5%
Cottonwood8.0%6.7%9.4%
Kearns V210.4%9.2%11.8%
Taylorsville (E)/Murray (W)10.0%8.7%11.4%
Taylorsville (West)9.6%8.3%11.2%
Murray9.7%8.4%11.2%
Midvale10.1%8.8%11.6%
West Jordan (Northeast) V29.7%8.3%11.3%
West Jordan (Southeast)9.2%7.9%10.6%
West Jordan (W)/Copperton9.2%8.0%10.5%
South Jordan V29.6%8.4%11.0%
Daybreak8.0%6.5%9.7%
Sandy (West)10.7%9.1%12.5%
Sandy (Center) V28.6%7.2%10.4%
Sandy (Northeast)11.1%9.0%13.6%
Sandy (Southeast)8.6%6.9%10.7%
Draper8.4%7.2%9.9%
Riverton/Bluffdale9.9%8.7%11.2%
Herriman8.5%7.5%9.6%
Tooele County (Other)10.4%8.2%13.1%
Tooele Valley11.1%9.8%12.5%
Eagle Mountain/Cedar Valley9.6%8.5%10.8%
Lehi10.1%9.2%11.0%
Saratoga Springs8.8%7.6%10.1%
American Fork9.6%8.4%10.9%
Alpine7.0%4.7%10.3%
Pleasant Grove/Lindon9.0%8.0%10.1%
Orem (North)8.7%7.6%9.8%
Orem (West)9.2%8.1%10.4%
Orem (East)8.3%6.8%10.1%
Provo/BYU7.2%6.2%8.4%
Provo (West City Center)8.3%7.3%9.4%
Provo (East City Center)8.2%7.1%9.5%
Salem City9.2%6.7%12.7%
Spanish Fork9.7%8.5%11.0%
Springville9.9%8.7%11.3%
Mapleton10.8%8.0%14.5%
Utah County (South) V29.2%7.4%11.5%
Payson9.8%8.3%11.5%
Park City8.8%7.0%11.2%
Summit County (East)10.4%8.1%13.4%
Wasatch County8.5%7.1%10.1%
Daggett and Uintah County9.4%8.1%10.8%
Duchesne County8.8%7.3%10.7%
Nephi/Mona9.5%7.2%12.5%
Delta/Fillmore10.2%7.7%13.3%
Sanpete Valley11.1%9.0%13.5%
Central (Other)10.1%8.3%12.3%
Richfield/Monroe/Salina12.6%10.3%15.4%
Carbon County10.4%8.3%12.9%
Emery County9.0%6.4%12.5%
Grand County6.6%4.3%9.9%
Blanding/Monticello9.5%6.6%13.5%
San Juan County (Other)8.8%6.0%12.6%
St. George9.2%8.2%10.2%
Washington Co (Other) V28.2%5.8%11.5%
Washington City8.2%6.6%10.0%
Hurricane/La Verkin9.4%7.7%11.4%
Ivins/Santa Clara8.3%6.1%11.2%
Cedar City11.0%9.8%12.4%
Southwest LHD (Other)9.3%7.6%11.4%
State of Utah9.4%9.3%9.6%
U.S.9.9%2017 final

Data Notes

Note: Utah Small Area represents area of mother's residence. A description of the Utah Small Areas may be found on IBIS at the following URL: [https://ibis.health.utah.gov/resource/Guidelines.html]. 2017 U.S. data is final. Preterm birth is calculated by obstetric estimate.

Data Sources

  • Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Preterm Births (Less Than 37 Weeks Gestation), Utah and U.S., 1997-2017

::chart - missing::

BRFSS Utah vs. U.S.YearPercentage of Live Born Infants
Record Count: 42
US Old Methodology199711.4%
US Old Methodology199811.6%
US Old Methodology199911.8%
US Old Methodology200011.6%
US Old Methodology200111.9%
US Old Methodology200212.1%
US Old Methodology200312.3%
US Old Methodology200412.5%
US Old Methodology200512.7%
US Old Methodology200612.8%
US Old Methodology200712.7%
US Old Methodology200812.3%
US Old Methodology200912.2%
UT New Methodology19979.9%
UT New Methodology199810.1%
UT New Methodology19999.2%
UT New Methodology20009.5%
UT New Methodology20019.3%
UT New Methodology20029.5%
UT New Methodology20039.5%
UT New Methodology200410.0%
UT New Methodology200510.1%
UT New Methodology20069.9%
UT New Methodology20079.5%
UT New Methodology20089.7%
UT New Methodology20099.8%
UT New Methodology20109.5%
UT New Methodology20119.4%
UT New Methodology20129.1%
UT New Methodology20139.1%
UT New Methodology20149.1%
UT New Methodology20159.3%
UT New Methodology20169.6%
UT New Methodology20179.4%
US New Methodology201010.0%
US New Methodology20119.8%
US New Methodology20129.8%
US New Methodology20139.6%
US New Methodology20149.6%
US New Methodology20159.6%
US New Methodology20169.9%
US New Methodology20179.9%

Data Notes

2017 U.S. data is final. U.S. data prior to 2010 is based on gestational age from last menstrual period (LMP) versus gestation based on the obstetric estimate. U.S. data of gestation based on the obstetric estimate has been revised back to 2010. Utah data is calculated by obstetric estimate. Beginning in 2010, national rates are reported using OE and are not consistent with rates reported before 2010.

Data Sources

  • Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention

References and Community Resources

[http://mchb.hrsa.gov][[br]] [http://www.cdc.gov/reproductivehealth/index.htm][[br]] [http://www.marchofdimes.com]

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 10/29/2018, Published on 11/27/2018
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 14 December 2018 5:35:15 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 27 Nov 2018 10:29:13 MST