Preterm births in Alaska are at a 20-year high, an indication of worsening maternal health, particularly among Alaska Natives. 

That’s according to a recent report from the Alaska Department of Health and Social Services that examines the number of preterm births in Alaska from 2000 to 2019. 

Preterm births, defined as babies born before 37 weeks, are bad for a number of reasons.

According to the Centers for Disease Control and Prevention, preterm births are linked with higher rates of death and disability, as well as breathing problems, feeding difficulties, cerebral palsy, developmental delay, vision problems and hearing problems. 

A 2018 CDC study found that babies born early and with low birth weight accounted for 17% of all infant deaths, defined as deaths before the age of 1. 

This is because babies continue developing throughout pregnancy, right up until the 39-week mark, when most babies are ready to enter the world. The lungs, liver and brain, in particular, are still growing and developing at the end of pregnancy. 

About 9.7% of all live births in Alaska were preterm in 2019, the DHSS study found. There’s been steady growth in the rate, too, with it increasing about 28% since 2012. 

Before that, it had been declining. The DHSS study found that preterm births decreased by 19.1% between 2003 and 2012. 

This mirrors national trends. The national preterm birth rate increased from the early 1980s to 2006, declined from 2007 to 2014, and rose again during 2014 to 2019.

The elevated number of preterm births is not due to what’s called spontaneous births, where the mother gives birth unexpectedly and early.

Instead, the increases are mostly in physician-initiated births due to complications with either the baby’s or the mother’s health. Almost all the increases were among mothers who gave birth in the 32 to 36 week range.

There were no increases in very preterm births, defined as between 28 and 31 weeks, or in extremely preterm births, which is under 28 weeks. 

Mothers’ health plays a large part in causing preterm births, the report finds. Maternal obesity was a risk factor in about 30% of preterm births, hypertensive disorders were found in about 26% of cases, diabetes in 17% and cigarette use in 22%. 

About 20% of mothers who gave birth to preterm babies received no medical care in the first trimester of pregnancy. 

This could be linked to that fact that preterm births afflict more historically disadvantaged groups. 

In Alaska, almost all the increase in preterm births was in Alaska Natives. Between 2012 and 2019, preterm births among Alaska Natives increased 9.5% to 13.5%, while the rate did not increase significantly among Asian, Black, Pacific Islander or White Alaskans. 

The report’s authors said there is not enough data to conclude definitively why this might be, but suspect that “cumulative social and physical exposures that stem from long-standing inequities” might play a role. 

Likewise, Black mothers in America have a preterm birth rate of 13.8%, according to a report from the March of Dimes, a non-profit that advocates for the health of mothers and babies. That’s far above the national average of 10.2%. 

American Indians and Alaska Natives, the March of Dimes report says, have the second highest rate among ethnic groups, at 11.6%. 

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