Stories tagged premature

Jul
14
2006

A whopping one in eight babies in the US is now born prematurely. (Doctors consider a baby “premature” if he/she is born before 38 weeks gestation.) And the US Institute of Medicine, in a report released yesterday, says urgent steps are needed to turn the tide.

Hanging in there: Premature infants born today are far more likely to survive, and at earlier ages, than those born even a decade ago. But they're also more likely to experience a whole host of both acute and chronic health problems. (Photo by maria mono)
Hanging in there: Premature infants born today are far more likely to survive, and at earlier ages, than those born even a decade ago. But they're also more likely to experience a whole host of both acute and chronic health problems. (Photo by maria mono)

You may be wondering, “What’s the big deal?” I kind of shrugged it off, too. After all, both of my kids were born at 37 or 38 weeks, and experienced no problems. And we’ve all heard miracle stories of babies born as early as 22–25 weeks surviving.

Turns out that’s the magic word—surviving—along with thriving.

About 20% of babies born before 32 weeks gestation don’t survive their first year, and many premature infants experience life-long health problems, such as asthma or other lung disease, cerebral palsy, blindness, hearing loss, and retardation or learning disabilities. Even babies born only a week or two early have additional health risks and 30% higher medical costs compared to kids born at 40 weeks.

Trying to keep premature infants alive and thriving costs the US $26 billion a year. No one’s suggesting that we shouldn’t do everything possible for these little guys, of course, but is there any way to improve the situation?

What causes premature birth?

Ah, if only we knew.

Infertility treatments are one cause: moms who take fertility drugs or undergo in vitro fertilization (IVF)are more likely to become pregnant with twins, triplets, or even higher order multiples, and those babies are far more likely to be born early than singletons. (62% of twins and 97% of other multiples conceived this way were born prematurely.)

But they explain only a fraction of the nation’s premature births.

Certain infections can cause early labor. Other risk factors are poor diet, obesity, maternal stress, lack of pre-natal care, and smoking. Mothers under 16 or over 35 are more at risk, as are poor women, and black women. But differences in socio-economic status and behavior don’t completely explain the problem, either.

(Interestingly, the rate of premature infants born to black women (17.8%) has decreased slightly in the last decade while it’s increased for infants born to white women (11.5%). The authors of the study say this is because black women are less likely to undergo fertility treatments increasingly used by white women.)

Truthfully, doctors don’t know what causes most preterm births or how to prevent them. And they have only a few tools to predict which women will experience preterm labor.

So what should we do?

The US Institute of Medicine recommends three things:

  • Doctors who practice IVF should implant fewer embryos at a time. (The issue in the US is this: insurance usually doesn’t cover the procedure, which costs roughly $15,000 a try, so doctors try to improve the odds of a woman getting pregnant by implanting several embryos at a time. Which sometimes works too well. Many countries in Europe allow doctors to implant only a single embryo at a time, but they also pay for multiple IVF attempts. Those countries have discovered that, despite paying more up front to achieve a pregnancy, they’re saving money on the back end by treating fewer premature infants.)
  • More pregnant women should undergo first trimester ultrasound exams. (This is the only way to be certain of the fetus’ age. With more and more women being induced or undergoing C-sections, it’s possible that some babies are being born prematurely because their parents and doctors thought they were older than they really were.)
  • And the government should increase funding for research into the causes and prevention of premature birth.