Decrease in U.S. preterm mortality seen in recent decades

From 1995-1997 to 2018-2020, there was an improvement in the preterm mortality rate in the United States, according to a study published online Sept. 5 in JAMA Pediatrics.

Tim Venkatesan, M.B., B.Chir., from UCL Great Ormond Street Institute of Child Health in London, and colleagues characterized trends in preterm infant mortality by maternal race and socioeconomic status in a retrospective longitudinal descriptive study using data for 12,256,303 preterm infant births between 1995 and 2020.

The researchers found that from 1995-1997 to 2018-2020, there was a decrease in the average U.S. preterm infant mortality rate (IMR) from 33.71 to 23.32 per 1,000 preterm births per year. The likelihood of dying following preterm births was higher for Black non-Hispanic versus White non-Hispanic infants (IMR, 31.09 versus 21.81 in 2018 to 2020); extremely premature Black and Hispanic infants had a narrow survival advantage once born (IMR rate ratio, 0.87 in 2018 to 2020). The rate of decrease in preterm IMR was higher in Black versus White and Hispanic infants. In addition, the rate of decrease was higher in nonsmokers versus smokers, in those with high versus intermediate or low levels of education, and in those who had versus had not received adequate antenatal care. Within each of these subgroups, the relative risk for preterm mortality widened over time.

"Unfortunately, we found an overall widening of the inequality in preterm mortality among mothers from socioeconomically disadvantaged groups. Our results confirm the critical importance of mothers receiving antenatal care," the authors write.

One author disclosed ties to the pharmaceutical industry.

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