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Dr. Alan Guttmacher

Director's Update

Reducing Preterm Birth Rates

Medical, scientific, and technological advances have revolutionized our world—from vaccines and antibiotics to genetics and a lab-on-a-chip, we continue to reap the benefits of our nation’s investment in biomedical research. Yet despite our progress, our nation has one of the highest rates of preterm birth among developed countries—about 11% of U.S. births in 2013 were “preterm.”

Preterm births occur before 37 completed weeks of pregnancy. Being born early increases an infant’s risk for immediate and long-term health problems ranging from mild disability to death. It also puts families at risk for economic, emotional, and other challenges.

How, then, can we focus our efforts to help give these infants and their families the best possible chance for healthy lives?

The March of Dimes recently announced a nationwide effort to reduce U.S. preterm births to 5.5% of all live births by 2030External Web Site Policy. More importantly than just improving the United States’ world ranking, realizing this goal would mean hundreds of thousands of infants whose health would be improved and whose families’ lives would be forever changed. Now that is something worth achieving.

The NICHD has worked for decades—often with partners including the March of Dimes—to better understand the causes of preterm birth, to find effective ways to prevent it, and to improve outcomes for infants born preterm. And we’ve made great strides, with a variety of important discoveries. Our research shows that:

However, our work is far from done. Our ongoing and new research initiatives and outreach activities represent important steps in reaching the 5.5% goal and in improving infant outcomes. For example, to aid in early prevention efforts, investigators are currently working to identify genes and other biomarkers that are associated with risk of preterm birth. Researchers are also evaluating the effectiveness of treating various infections that are linked to preterm birth. Our efforts also focus on improving health outcomes for preterm infants.

We recently launched the Human Placenta Project to learn more about this poorly understand organ, so critical to our health. Problems with the placenta are responsible for many poor pregnancy outcomes, including preterm birth and stillbirth. Understanding how the placenta functions could lead to interventions that prevent or resolve problems that may lead to an early birth.

Is It Worth It?, a recent outreach initiative from our National Child and Maternal Health Education Program, stresses the importance of waiting until at least 39 weeks to deliver a baby unless there is a medical reason to deliver earlier. Research from the NICHD shows that babies born at 37 and 38 weeks of pregnancy—once considered “term”—are at higher risk for health problems than are those born at 39 weeks or later. This initiative, geared toward families and health care providers, directly corresponds to the March of Dimes strategy of eliminating elective deliveries before 39 weeks to reduce the overall preterm birth rate.  

In this month of Thanksgiving, we thank the March of Dimes for reminding us that while our nation has much to be thankful for, we must continue and expand our efforts to further reduce the rate of preterm birth—a worthy goal indeed.

Last Updated Date: 11/17/2014
Last Reviewed Date: 11/17/2014

About the Director

Alan Guttmacher, M.D., assumed the duties of NICHD Acting Director on December 1, 2009. A pediatrician and medical geneticist, Dr. Guttmacher came to the NIH in 1999 to work at the National Human Genome Research Institute (NHGRI), where he served in a number of roles, including Deputy Director from 2002 to 2010, and Acting Director from 2008 to November 30, 2009.

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