This is a recurring theme in health care in this country. We spend billions of dollars caring for health problems afflicting the less fortunate members of our society. Very often, we could avoid or at least reduce these health problems with a little preventive care earlier in the process. That has once again proven to be the case with preterm births.

The typical term of a pregnancy is considered to be 40 weeks. Any birth before 37 weeks of gestation is considered to be a preterm birth. The earlier the birth, the worse it is for the baby.
Preterm births have been on the rise since 2014. They are associated with a whole host of health problems most often related to the fact that the baby has not fully developed by the time she or he is born. Premature infants are at higher risk for apnea of prematurity, hypoxic-ischemic encephalopathy, retinopathy of prematurity, cerebral palsy, brain bleeds, cardiovascular problems, various respiratory distress syndromes, chronic lung disease, gastrointestinal and metabolic disorders, feeding difficulties, blood disorders, including anemia, and infection to name only a few. Most of these ailments can lead to death. A third of preterm babies die as a result of their prematurity. Even if the preterm infant survives, the effects of the early birth may persist for the rest of his or her life.
The costs of treating the preterm infant can be astronomical. A stay in the Neonatal Intensive Care Unit is almost always necessary. Depending on the degree of prematurity and the severity of any complications, the stay may be a long one. There may also be significant costs for treatment of complications of prematurity throughout the remainder of the child’s life.
Like many other health problems, preterm births are more common among those who are further down the economic ladder. They do not have access to good health care to start. They often live in “food deserts” where it is hard to get nutritious foods. Virtually all of the amenities that the well-to-do have which improve their health outcomes are lacking in our poorer communities. There is hope, however.
A cross-sectional study out of the University of California San Francisco found that increasing social spending, even if only by a few thousand dollars to purchase better food and housing resulted in lower rates of preterm births, especially among Black women. Every thousand dollars spent resulted in a 1.4% reduction in preterm births overall and a 4.3% reduction among Black women. Given the costs associated with care for preterm infants and the potential for a lifetime of disability and costs to society, even a small reduction in preterm births can reduce much misery and save taxpayers a lot of money.
If this study is like all of the studies which have preceded it, it is not going to result in much change. Study after study has shown that, as the old adage goes, “An ounce of prevention is worth a pound of cure.” We know that money spent to keep patients healthy will save money in the long run, but politicians still routinely refuse to spend money on health care for the poor. This results in a sicker population of poor people who are not able to be productive members of society and whose health care needs in later life cost taxpayers lots of money. It is truly a case of “Pay me now or pay me (more) later.” When will we learn?
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