The Institute of Medicine, an independent group that advises the federal government on medical issues, estimates that there has been a 30 percent increase since 1981 of premature births rates in the United States.
The Institute says use of in-vitro fertilization and other assisted reproductive technologies has risen dramatically in the past 20 years and more older women are having children. A previous preterm baby apparently doubles the risk of a second and carrying twins increases prematurity risk by 40 percent, odds that worsen with triplets or more. Those born before 32 weeks face the greatest risks of death and about one-fifth don't survive a year and survivors often have devastating disabilities such as cerebral palsy and mental retardation. Even babies born just a few weeks early can face developmental delays and other problems.
The Institute is recommending that more pregnant women receive a first-trimester ultrasound exam, which is the only way to be certain of the fetus' exact age and is particularly important if the woman later has labor induced or a Caesarean section before her due date. They also want stronger guidelines that reduce the number of multiple births as a result of infertility treatment.
The cause of most preterm births is unclear and doctors are at a loss when it comes to preventing them, and urgent research is needed to try to turn the tide.