Have preterm births peaked?

Preterm births in the United States went up steadily from 1981 to 2006, but now they seem to be going back down, according to a new report from the National Center for Health Statistics in Hyattsville, Md.

This is the first two-year downturn in nearly three decades, the report states.

The peak year for preterm births was 2006, when they accounted for 12.8 percent of all births. The rate in 2008 was 12.3 percent.

A preterm birth is one that occurs before 37 weeks of gestation. Babies born before this point are more likely to have serious health problems compared with infants born later in pregnancy. Even babies just shy of 37 weeks are more likely to have "neurodevelopmental problems," or to die before they turn one year old, than are babies born at term, the report states.

Preterm rates appear to be falling among women of all age groups younger than 40, among all ethnic groups, in all types of deliveries and in most parts the country. Several states saw a flat rate of preterm births over the last two years, but only Hawaii experienced an increase. The decrease was similar for singleton and multiple births.

However, the report notes that "the U.S. preterm birth rate remains higher than in any year from 1981 to 2002, with large differences still evident by race and Hispanic origin. Further research is necessary to explain the factors behind the current downturn and to develop approaches to help ensure its continued decline."

C-sections at all-time high in new CDC report

The rate of births that ended in Caesarean-sections climbed by 53% in the years between 1996 to 2007, when they stood at 32%, the highest rate ever reported in the United States, the National Center for Health Statistics reported on Tuesday.

The rate is higher than those most other industrialized countries are experiencing, according to the report from the NCHS , which is an arm of the Centers for Disease Control, based in Atlanta, Ga. The cost of a C-section is almost double that of a vaginal delivery, the report notes.

C-sections were up for all groups across the board in the 11 years that were the major focus of the study, in terms of age, race, location, and how far along women were in their pregnancies.

About 1.4 million women gave birth by Ceasarean in 2007. In 2006, Caesarean delivery was the surgical procedure most often performed in American hospitals.

Here are the major findings of the report:

The U.S. C-section rate, 21 percent in 1996, was 32 percent in 2007, an increase of 53 percent. The steepest rise occurred between 2000 and 2007.

C-section rates went up by 50 percent or more in 34 states. In six states -- Colorado, Connecticut, Florida, Nevada, Rhode Island, and Washington -- the rate increased by more than 70 percent.

The rate rose for women of all age groups, with women under 25 having greatest rate of increase, 57 percent.

All racial and ethnic groups experienced increases. Black women had the highest C-section rate in 2007, 34 percent. Native American women had the lowest rate, 28 percent.

Caesarean rates increased for deliveries of infants of all gestational ages. C-sections for pre-term babies (less than 34 weeks gestational age) increased 36 percent; the rates for late pre-term babies (34 to 36 weeks) and term and post-term babies (37+ weeks) went up nearly 50 percent.

Early and late pre-term babies were more likely to be delivered by Caesarean section than were babies born at 37+ weeks.

The report cited possible reasons for the increases in Caesarean sections, in addition to medical indications for the surgery, as "maternal demographic characteristics," like advanced maternal age, fears of malpractice suits among physicians, doctors' preferences, and maternal preferences.