Born a Little Too Soon

Industry leaders in prenatal care could pat themselves on the back.

After all, survival rates for premature babies have improved dramatically over the last 50 years.

In 1950, there were 29.2 deaths in premature babies for every 1,000 births in America.

That figure dropped to seven in 2002, according to the March of Dimes, a charitable organization that specializes in babies’ health.

Yet, Lisa Dye isn’t satisfied.

That number still bugs Dye, the director of program services in Illinois for the March of Dimes.

“Premature birth is still a big problem,” she said. “Women can do everything right leading up to their pregnancy and can still have their baby born prematurely.”

About 12.5 percent of babies in the U.S. are born prematurely. Regular pregnancies last about 40 weeks and any birth that takes place before the 37th week of pregnancy qualifies it as a premature birth. Babies born between 37 and 42 completed weeks of pregnancy are called full term. Babies born before 37 completed weeks of pregnancy are called premature. In the United States, about 12.8 percent of babies (more than half a million a year) are born prematurely.

Cathy Gray, the perinatal network administrator at the University of Chicago, said perinatal care has shifted its way of thinking.

What was a breakthrough then is now nothing more than day-to-day operations.

“In the seventies, you were looking at saving a 3-pound baby as a big deal,” Gray said. “Now, saving a baby that is 1 pound, 3 ounces is not even huge.”

Even when premature babies survive, their fight has just begun.

Babies born before the 40th week of pregnancy are at a much greater risk for a slew of post-birth complications.

Dye said cystic fibrosis, mental retardation and learning disabilities are of common complications for premature babies.

“When they are born, they may have a number of surgeries,” Dye said.

Survival rates have improved throughout the years, but the number of preterm births has skyrocketed. According to the Mayo Clinic, there has been a 30-percent increase in premature births in the last two decades alone.

Gray said on average, there are 11,205 babies born each day. And out of those, 1,367 are born prematurely.

Advancements in prenatal care have helped to combat those numbers.

Gray said there are a number of techniques being used. Aside from advanced ultrasonography, Gray said simple teaching has become a mainstay in prenatal care.

Having obstetricians in the room at the same time can help better prepare if other techniques have failed.

And regardless of how many techniques are used, complications from premature birth almost always arise.

“Any baby born early will be at risk,” Gray said. “All of their organs will be underdeveloped. Their brains aren’t ready to deal with being outside (the womb). Their lungs don’t mature.”

Although professionals have been able to reverse mortality rates, they have yet to pinpoint exact causes behind premature birth.

Even mothers who methodically follow textbook procedures for having a healthy pregnancy are still at risk for delivering prematurely.

Industry leaders have, however, been able to identify some risk factors that can the strengthen the chance of shorter gestation periods and preterm births.

It’s a matter of taking care of yourself.

“Education also plays a key role,” Dye said. “Everyone individually plays a role. Having a healthy pregnancy is taking care of yourself.”

Another risk factor, albeit unavoidable, is the number of babies in the womb. A March of Dimes study found 54 percent of twins were born prematurely while only about 9 percent of single births were before 37 weeks.

Once premature babies are born, there is a very complicated road to travel. It’s often a long road, too.

Without mature organs, premature babies are in a delicate state. It routinely can be a half-year before they can even leave the hospital. Isolettes help maintain a safe environment and control the air temperature. Usually, premature babies can also benefit from oxygen tubes because their lungs aren’t capable of producing ample oxygen. A feeding tube is also a staple in premature care.

The advancements have been many.

Gray realizes that — and she realizes advancements in her field mean saving lives.

“The survival rates are enormous,” Gray said. “Quality of life has improved also.”

Did you know?

Women with periodontal disease are three to five times more likely to deliver a premature baby than women in good periodontal health.
In 2000 prematurity/low birthweight was the leading cause of neonatal mortality in the U.S., accounting for 23 percent of deaths in the first month of life.
Major risk factors associated with increasing rates of preterm delivery include multiple births, advanced maternal age, induced deliveries and additional factors as yet unknown.
Preterm labor/delivery is the No. 1 obstetrical challenge in the United States.

Risk Factors for preterm labor include: