I haven't seen the actual report, just a news article about it, but for those of us who work in the field this is not a surprise. We've known for a number of years that the rate of prematurity is increasing. We've also known for a number of years that we don't know why the rate of prematurity is increasing, and we certainly don't know how to prevent it.
We know that certain infertility treatments increase the risk of multiple births, which increases the chance of premature delivery, but that accounts for just a small proportion of the increase. The report recommends that we take steps to decrease the number of multiple birth pregnancies - such as implanting only one or two embryos when doing in vitro fertilization - but that's just a drop in the bucket. For years, I've heard people saying we need more research into causes of prematurity, and we do. It just makes you feel a little impotent to be able to do nothing more about it besides call for more research.
Often reports like these are accompanied by hand wringing about how bad the U.S.'s infant mortality rate (IMR) is. We are far from first in the world in that measure of public health. I think we're around 20th, although I haven't looked it up recently. About now we will also likely hear statements meant to shame us that say the infant mortality rate in some of our inner cities is the same as that of some third world countries. These are bad things, but I'd like to point out one reason why our infant mortality rates will never be best in the world.
Blacks have a higher rate of premature birth than whites, 17.8% versus 11.5%. We don't know why that is, but it seems to be a biological phenomenon, and not just due to socioeconomic factors. Blacks of the same educational and economic levels as white counterparts still have more premature births. Since premature birth is one of the main contibutors to the infant mortality rate, countries that have more blacks are going to have a higher infant mortality rate. We are never going to be able to compete, in terms of infant mortality rate, with countries with more homogeneous populations like Japan (a perennial high achiever in IMR) and the Scandinavian countries.
I'm not saying we should be proud of our showing in the IMR rankings, or that we shouldn't try to improve it. I guess I'm just trying to point out that our high IMR is not a blanket indictment of our health system, as some would have it.