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WV ranks fourth in premature birth rates

By BISHOP NASH

The Herald-Dispatch

HUNTINGTON, W.Va.  — Nearly 12 percent of babies delivered in West Virginia are now born premature — placing the Mountain State (11.8 percent) fourth behind Mississippi (13.6 percent), Louisiana (12.6 percent) and Alabama (12 percent) for the highest percentage of preterm births.

Those relatively high rates have earned each of those states an F grade from the March of Dimes’ 2017 Premature Birth Report Card.

The four states, along with Puerto Rico (11.5 percent), were the only state-level entities issued Fs by the March of Dimes, which grades premature birth rates of states, counties and major cities against the organization’s goal of falling to 8.1 percent by 2020.

The nation’s preterm birth rate of 9.8 percent earned a C grade. That was a two-tenths of a percent increase from 2015.

Of West Virginia’s 55 counties, 19 earned F grades, including Cabell, Wayne, Lincoln, Mingo, Logan, Boone, Wyoming, Kanawha and Raleigh. D grades were issued to another 19 counties, including Mason County. Putnam County earned the highest letter grade in the Tri-State with a C.

Ohio (10.8 percent) and Kentucky (11.4 percent) fared only slightly better, both earning D grades.

Lawrence County, Ohio, received an F with the second-highest percentage of premature births (12.3 percent) among Ohio’s 88 counties — just behind Clark County’s leading 12.5 percent. Gallia, Jackson and Scioto counties all earned D grades.

In the Kentucky portion of the Tri-State, F grades were issued to Boyd, Carter, Lawrence and Greenup counties.

While West Virginia was rated poorly as a whole, a few counties scored markedly higher — particularly those in or near the state’s Northern and Eastern panhandles. Berkeley County, which contains Martinsburg and is about an hour’s drive from Washington, D.C., was one of the few counties to earn an A.

Monongalia County, which contains Morgantown and is about 45 minutes away from Pittsburgh, Pennsylvania, earned a B.

Comparing the highest-scoring counties in the panhandles to those in the southern coalfields reveals the socioeconomic disparity among the state’s regions, noted Dr. Kelly Cummings, assistant professor in the department of obstetrics and gynecology at Marshall University’s School of Medicine. An area’s percentage of premature births tends to correlate along the lines of other chronic medical conditions such as obesity, diabetes and tobacco use.

Pregnant women in rural areas are also less likely to have ready access to prenatal care or may have to travel hours to one of the state’s handful of delivery hospitals.

“The No. 1 issue is women needing to seek prenatal care and taking care of themselves early on,” said Cummings, a board-certified maternal-fetal medicine specialist. “The state also needed to help get information to women about where they can get care even if they don’t have insurance so they can be diverted to the right direction.”

While access to care would not seem to be as much a problem for Cabell and Kanawha counties, which house two delivery hospitals each, Huntington and Charleston’s metro areas are home to two of the state’s largest African-American communities, Cummings added. In West Virginia, the premature birth rate among black mothers is 35 percent higher than that of white mothers: 14.4 percent to 10.7 percent. African-American women are more likely to develop pre-eclampsia — the onset of high blood pressure — during pregnancy, which is often cause for induced premature labor in order to spare the mother’s health.

While pre-eclampsia and underlying lifestyle concerns correlate, the root cause of all premature birth remains largely a medical mystery, said Dr. Sean Loudin, neonatologist at Cabell Huntington Hospital and assistant professor at Marshall’s School of Medicine.

“I think there’s many factors, and we simply do not know all the causes to all those cases, and I don’t know if we ever will from a holistic standpoint,” he said.

However, though NAS alone is not cause for premature birth, Loudin said mothers who use opioids during pregnancy often live an unhealthy lifestyle in other ways and may not seek regular prenatal care.

But a slight increase in premature births may hide a silver lining, Loudin speculated. The advances in medical science, even over the past five years, may be allowing hospitals to give more infants a chance at life.

“That was my first reaction to it,” said Loudin, referring to the March of Dimes study. “There are some practices that are saving 22-week-old infants, so those babies would have been considered a still-birth even three to four years ago, but now they’re live births.

“(Obstetricians) are now feeling more comfortable in delivering a premature baby.”

Premature or preterm birth is defined as any gestation less than 37 weeks. While premature births require a stay in the hospital’s neonatal intensive care unit for the infant’s first days or weeks, premature birth does not tend to be fatal, and most premature babies continue to develop as normal.

Percentage of babies born premature, 2012-15 average

West Virginia

State average: 11.8% (F)

Cabell: 12.5% (F)

Wayne: 11.9% (F)

Lincoln: 12.9% (F)

Mason: 11.3% (D)

Putnam: 9.7% (C)

Mingo: 11.8% (F)

Logan: 12.4% (F)

Boone: 15% (F)

Wyoming: 12.9% (F)

Kanawha: 13.2% (F)

Raleigh: 11.8% (F)

Ohio

State average: 10.8% (D)

Lawrence: 12.3% (F)

Gallia: 10.5% (D)

Scioto: 10.9% (D)

Jackson: 10.5% (D)

Kentucky

State average: 11.4% (D)

Boyd: 13.3% (F)

Carter: 12.6% (F)

Lawrence: 12.2% (F)

Greenup: 13.6% (F)

National average, 2016: 9.8% (C)

Source: National Center for Health Statistics

Follow reporter Bishop Nash on Twitter @BishopNash.

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