Illinois received a failing grade from the March of Dimes for the state’s premature birth rates, which are higher than the national average.

Illinois was one of 18 states to earn a D nationwide, the same letter grade given recently to the country as a whole, because more than 13 percent of all births were premature. That figure is up 11 percent from 1995, according to the organization’s report card. Overall, the state ranked 31st in the nation.

“It is unacceptable that our nation is failing so many preterm babies. We are determined to find and implement solutions to prevent preterm birth, based on research, best clinical practices and improved education for moms,” Dr. Jennifer L. Howse, president of the March of Dimes, said in a prepared statement.

Dr. Jonathan Muraskas, professor of pediatrics and neonatal medicine and physician at Loyola Hospital in Maywood, said 4 million babies are born every year in the United States and about 15 percent, almost half a million, are born premature.

“A full term is 40 weeks,” he said. “Anything less than 37 weeks is premature.”

Multiple births and poor prenatal care can lead to premature births, Muraskas said. Some women tend to put off having children until later in life to focus on their careers. The longer a woman waits, more problems can arise and infertility can occur, he said.

Twins can often add to premature births because they usually deliver at 37 weeks, Muraskas said.

Major problems are a lack of prenatal care and an uninsured population.

“I think it has to do with access to health care and affordable health care,” Muraskas said. “Education is the best prenatal education ok and the best medicine to prevent prenatal births.”

Dr. Lori Walsh, a pediatrician at Glenbrook Pediatrics in Glenview, said poorer urban areas seem to have more premature births.

“I’m in a suburban practice and we don’t take public aid, so we don’t see that many cases here,” she said. “But when I was at (Children’s Memorial Hospital) we did; you see a different set of clientele.”

Walsh said the difference largely was because of a lack of health care.

“It really is dependent on access to health care,” she said.

Problems result because the infant’s internal organs are not always mature and complications after birth often mean lengthy and costly hospital stays.

“The brain is not fully developed,” said Lindsay Rodriguez, community director with the Peoria chapter of the March of Dimes. “There is a range of things that can happen.”

The nonprofit organization, which aims to reduce problems at birth through education and research, set a preterm birth rate of 7.6 percent or less, the government’s “Healthy People 2010” goal, as a cutoff for an A.

Vermont gained the highest grade, a B, with 9 percent while Mississippi rounded out the bottom with an F at 18.8 percent. This is the first year for the premature birth report card, and the charity says it plans to make it an annual event.

Rodriguez said while the study did not find a clear reason behind the premature births in Illinois, it did make a strong link between the health habits of mothers and the likelihood of a preterm birth.

At Loyola Hospital, Muraskas said about 400 premature births will occur in about a year.

“In Loyola, in the western suburbs, we can still see people from Oak Brook and Wheaton and (people of) less economic areas,” he said. “It is kind of a melting pot — I think Loyola represents a good model.”

The most common reason a mother would go into labor early is because of infection. Once a mother develops an infection, stopping labor becomes impossible, according to Muraskas.

“Even in the best of pregnancies it can happen, even with the best of care it can still happen,” he said. “Even in the best hands and best of circumstances, water can break and there is not much hope.”

On Oct. 15, Rosa Guzman of Maywood gave birth to her first child, Emiliano, who was premature by 10 weeks and weighed 3 pounds 11 ounces.

A few years ago, doctors told Guzman she had to have uterine fibroid embolization, which is a treatment for fibroid tumors of the uterus. Afterward, she was told she would not be able to get pregnant — or if she did the baby probably would be premature.

“Well, it happened. My water broke and I went into the hospital on Oct. 10 and they were trying to keep him in as long as possible,” Guzman said.

A few hours later, Guzman was told she needed to go into surgery because the baby was on his way.

“When I was waking up, the nurse had come and told me it was over but at that moment she didn’t say I had a baby boy,” Guzman said. “I started to cry and she was like why are you crying, it was a baby boy.”

Emiliano was taken upstairs to the neonatal unit. The first look at her new baby caused Guzman to become emotional with thoughts running through her head of what might have done wrong.

“Just seeing him there, it was very hard,” Guzman said. “They are fighting for their life trying to survive and there is nothing I can do.”

Emiliano weighs 7 pounds now and might be released from the hospital the first week of December.

Guzman said the staff at Loyola Hospital has been great. Doctors and nurses have explained everything to her in great detail. She is at the hospital every day for eight to 10 hours, but nurses still make sure she is up-to-date with everything that has gone on with Emiliano.

“I have no complaints. I am very happy,” Guzman said. “They have been excellent; he couldn’t have gone to a better hospital.”

The plan was to have one more child. However, when Guzman spoke to her doctor, he said before planning on having another child she would need to speak to the doctors who specialize in high-risk pregnancies.

“The risk of having another preemie are greater,” Guzman said. “It makes me sad, but at least I have this little guy.”

Dr. Stavros Ionides, medical director of neonatology at Adventist Hinsdale Hospital, said they have seen a rise in premature births. The rise could be because of the hospital’s status as a level 3 trauma center, a designation by the Illinois Department of Public Health that the hospital offers the highest degree of quality care for high-risk moms and high-risk newborns. The hospital’s three sister hospitals, Adventist Bolingbrook, GlenOaks and La Grange Memorial, transfer their premature birth patients to Adventist Hinsdale.

Ionides said he believes the percentages are up in Illinois because wherever there is poverty and lack of access to health care, there is an increase in premature births. Many mothers who don’t have physicians guiding them on a regular basis often end up going to the emergency room when there’s a problem and it’s too late, Ionides said. Without regular prenatal visits, mothers can get hypertension, high blood pressure or other factors that might lead to a premature birth.

“You will never be able to eliminate premature births, but we need to improve in the areas of poverty, education and access to health care,” Ionides said.

Danya Hooker contributed to this report.