A recent publication by the US Centers for Disease Control and Prevention (CDC) reports the trends of birth by gestational age from 2014 to 2023. In that timeframe, the rates of preterm and early term births increased, while those of full term and late-term births decreased. The proportion of early term births with induced labour has also increased, though maternal age (under or over 30 years) does not affect the risk of early term birth.
The publication, which was compiled from the CDC National Vital Statistics System (NVSS), detailed the rate of births in 2014 and 2023 by gestational age. Gestational age was categorised into preterm (under 37 weeks), early term (37 to 38 weeks), full term (39 to 40 weeks), and late and post-term (41 weeks and over). These definitions were defined and adopted by the American College of Obstetrics and Gynecology (ACOG) in 2013. The range of gestational age from 37 weeks to 42 weeks was previously considered equivalent.
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There have been measured differences in health outcomes of newborns dependent on gestational age. Preterm and early term births have been associated with an increased risk of low birth weight, small size for gestational age, large size for gestational age, low APGAR scores at birth, NICU stays and in-hospital mortality. These risks each decrease as gestational age approaches 39 weeks. Long-term effects of preterm and early term births include lower cognitive scores than babies born at between 39 and 41 weeks.
The CDC reported that preterm births rose from 7.74% of births in 2014 to 8.71% of births in 2023. This trend was also seen in early term births, which rose from 24.31% of births in 2014 to 29.64% of births in 2023. The opposite effect was recorded in full-term and late and post-term births: full-term births dropped from 60.76% of births in 2014 to 56.68% of births in 2023, and late and post-term births declined from 7.20% of births in 2014 to 4.97% of births in 2023. When investigating maternal age, the proportions of early term births were comparable in women under 30 years and in women 30 years and older in both 2014 and 2023.
The proportion of earl term births in which labour was induced has risen by 77%, from 17.7% of induced early-term births in 2014 to 31.3% in 2023. In 2021, the ACOG released a committee opinion detailing situations in which preterm and early term births are medically recommended. These scenarios include placenta praevia, previous uterine rupture, foetal growth restriction, abnormal umbilical artery Doppler studies, oligohydramnios, pre-eclampsia, intrahepatic cholestasis and pre-labour rupture of membranes. It is unclear whether these situations have increased in frequency from 2014 to 2023, or if these recommendations are being more carefully followed since their publication in 2021.
GlobalData epidemiologists anticipate 369,244 diagnosed prevalent cases of preterm birth in the US in 2025. This is likely to increase in the following years, considering the trend from 2014 to 2023 and the ACOG recommendations for preterm and early term birth. There are some risk factors for preterm birth, such as young (teenage) or advanced (over 35 years) maternal age, prior preterm birth, and tobacco and drug use. Prenatal care and following recommendations for pregnancy may help alleviate this risk.
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