Prematurity Awareness Month

November is Prematurity Awareness Month, when Healthy Start works with national health agencies like the March of Dimes to promote healthy births and healthy Moms.

More than half a million babies are born too early each year in the United States. Our nation’s rate of premature birth increased by 36 percent over the last 25 years. That’s serious cause for concern.

The cost of prematurity is more than $26 billion a year. Severe heath problems and lifelong disabilities are common risks to infants born too soon. Premature birth is the number 1 killer of newborns.

What we know about prematurity

Today more than 1,400 babies in the United States (1 in 8) will be born prematurely. Many will be too small and too sick to go home. Instead, they face weeks or even months in the newborn intensive care unit (NICU). These babies face an increased risk of serious medical complications and death; however, most, eventually, will go home.

But what does the future hold for these babies? Many survivors grow up healthy; others aren’t so lucky. Even the best of care cannot always spare a premature baby from lasting disabilities such as cerebral palsy; intellectual disabilities and learning problems; chronic lung disease; and vision and hearing problems. Half of all neurological disabilities in children are related to premature birth.

Although providers have made tremendous advances in caring for babies born too small and too soon, we need to find out how to prevent preterm birth from happening in the first place. Despite decades of research, scientists have not yet developed effective ways to help prevent premature birth.

In fact, the rate of premature birth increased by more than 20 percent between 1990 and 2006. This trend and the dynamics underlying it underscore the critical importance and timeliness of the March of Dimes Prematurity Campaign. The rate fell to 12.3 percent in 2008 from 12.7 in 2007, a small but statistically significant decrease.

Who is at increased risk?

Preterm labor and birth can happen to any pregnant woman. But it happens more often to some women than to others. Researchers continue to study preterm labor and birth. They have identified some risk factors, but still cannot predict which women will give birth too early. Having a risk factor does not mean a woman will have preterm labor or preterm birth. Three groups of women are at greatest risk of preterm labor and birth:

  • Women who have had a previous preterm birth
  • Women who are pregnant with twins, triplets or more
  • Women with certain uterine or cervical abnormalities

If a woman has any of these three risk factors, it’s especially important for her to know the signs and symptoms of preterm labor and what to do if they occur.

Some studies have found that certain lifestyle factors may put a woman at greater risk of preterm labor. These factors include:

Late or no prenatal care
Drinking alcohol
Using illegal drugs
Exposure to the medication DES
Domestic violence, including physical, sexual or emotional abuse
Lack of social support
Extremely high levels of stress
Long working hours with long periods of standing
Exposure to certain environmental pollutants

Certain medical conditions during pregnancy may increase the likelihood that a woman will have preterm labor. These conditions include:

Infections (urinary, vaginal, sexually transmitted; possibly others)
High blood pressure and preeclampsia
Clotting disorders (thrombophilia)
Bleeding from the vagina
Certain birth defects in the baby
Being pregnant with a single fetus after in vitro fertilization (IVF)
Being underweight before pregnancy
Short time period between pregnancies (less than 6 to 9 months between birth and the beginning of the next pregnancy)

Medical researchers also have identified certain groups of women who are at increased risk of having a premature baby. These groups include:

African-American women
Women younger than 17 and older than 35
Women who have a low income

Experts do not fully understand why and how these factors increase the risk that a woman will have preterm labor or birth.

Are there complications in the newborn?

Some premature babies face serious complications, including:

Respiratory distress syndrome, which is a serious breathing problem that affects mainly babies born before 34 weeks of pregnancy.

Bleeding in the brain, called intraventricular hemorrhage (IVH), which is most common in babies born before 32 weeks of pregnancy. It can cause pressure in the brain and brain damage.

Patent ductus arteriosus, which is a heart problem that is common in premature babies. Untreated, it can lead to heart failure.
Necrotizing enterocolitis (NEC), which is a potentially dangerous intestinal problem.

Retinopathy of prematurity (ROP), which is an eye problem that occurs mainly in babies born before 32 weeks of pregnancy. In severe cases, treatment is needed to help prevent vision loss.

Worth the Wait: Keep your baby at least 39 Weeks

More and more women and practices are scheduling births rather than waiting for labor. Moms need to know why waiting 39 weeks is important for their health, and their baby’s health.

Why 39 Weeks?