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 Prematurity — It's a Bigger Problem Than You Think

 

Article by: K. Lynn Kammermeyer, Ph.D., Director of Program Services
Idaho State March of Dimes

 

 

 


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What is Preterm Birth?

Most pregnancies last around 40 weeks. Babies born between 37 and 42 weeks of pregnancy are called full-term. Babies born before 37 completed weeks of pregnancy are called premature or preterm. Almost 12 percent of babies in this country are preterm.

Of those, the majority (about 83 percent) are born between 32 and 36 weeks of gestation. About 10 percent are born between 28 and 31 weeks of gestation, and about 6 percent are born at less than 28 weeks of gestation. All babies born preterm are at risk for serious health problems, but those born earliest are at greater risk of long-term disabilities and death. Fortunately, advances in obstetrics and neonatology, the branch of pediatrics that deals with newborns, have improved the chances for survival for even these smallest babies.

Babies born preterm face a greater risk of serious health problems for several reasons. The earlier a child is born, the less s/he will weigh, the less developed his/her organs will be, and the more complications s/he is likely to face. These babies usually require care in a neonatal intensive care unit (NICU), which has specialized medical staff and equipment to deal with the multiple problems faced by premature infants.

Very premature babies also have the highest risk of death and lasting disabilities, such as mental retardation, cerebral palsy, lung and gastrointestinal problems, and vision and hearing loss.


What Causes Preterm Birth?

A baby may be delivered preterm after a doctor induces labor due to pregnancy complications or health problems in the mother. However, most preterm births are a result of preterm labor (which may follow premature rupture of the membranes or PROM). The causes of preterm labor and PROM are not fully understood, but the latest research suggests that many cases are triggered by the body’s natural response to certain infections, including infections involving the amniotic fluid and fetal membranes. However, in most cases, a doctor cannot determine why a woman delivered preterm. And, at this time, there often is little the doctor or the pregnant woman can do to prevent preterm labor.

Studies suggest that certain factors increase a woman’s risk of delivering preterm:

• Previous preterm birth;
• Expecting twins or other multiples;
• Uterine or cervical abnormalities;
• Obstetric complications (such as placental problems) ;
• Smoking, drinking alcohol, or using illicit drugs;
• Age under 18 or over 35; and
• Maternal or fetal stress.

The March of Dimes
Prematurity Campaign

The March of Dimes ha a nationwide, five-year Prematurity Campaign, investing $75 million dollars to increase research, awareness, and education around the problems of prematurity to help American families have healthier babies.

Many people do not realize that premature birth is a problem and that it continues to get worse. The problem of prematurity:

• More than 467,000 babies (about 1 in 8) are born prematurely each year in the U. S.;
• The rate of premature birth has increased over the last three decades. The current rate (2001) is 11.9 percent, the highest ever recorded;
• Nearly half of all premature births have unknown causes;
• Prematurity is the leading cause of infant death in the first month of life;
• 50 percent of babies born early suffer from lifelong health problems;
• In 2001, more than 2000 babies were born too soon (and often too small) in Idaho;
• While Idaho’s premature birth rate of 10.2 percent is lower than the national average, it has risen 17 percent since 1990.

The two goals of the March of Dimes Prematurity Campaign are to raise public awareness of the problems of prematurity and to measurably reduce the rate of prematurity. The March of Dimes will develop activities in five areas to achieve these goals:

1. Raise public awareness of the problems of prematurity;

2. Educate pregnant women and their families to recognize the signs of preterm labor. Support parents of babies in neonatal intensive care units (NICU);

3. Assist health care practitioners to improve prematurity risk detection and address risk-associated factors;

4. Invest more public and private research dollars to identify causes of preterm labor and prematurity, and to identify and test promising interventions; and

5. Expand access to health insurance to improve prenatal care and infant health outcomes.

The March of Dimes has partnered with a number of organizations including the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the Association of Women’s Health, Obstetric & Neonatal Nurses (AWHONN).

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