Preterm birth prevention is focus of study

Shayden Alexander was born 12 weeks too soon, weighing in at 1 pound 7 ounces upon his delivery Dec. 16.

He was one of an estimated 90 babies in Nevada that week to be born prematurely, meaning the birth was at least three weeks before the due date.

Many, like Shayden, would spend months in specialized hospital units connected to breathing and feeding tubes and monitors. Their bodies, which sometimes can fit in the palm of an adult hand, are pricked and prodded as specialists such as cardiologists, pulmonologists and gastroenterologists check their internal organs to ensure proper development.

Technology and expertise are available here to help their development, but the costs to care for preemies runs into the millions of dollars. Some health officials say this kind of specialized care, though necessary, is driving up medical care costs.

"That tiny plastic environment they are in is the most expensive hospital bed in the United States,” said Iain Buxton, professor of pharmacology and obstetrics and gynecology at the University of Nevada School of Medicine.

"Prematurity results in the death of thousands of babies each year, leaves thousands more disabled for life and costs the economy $26 billion every year. This is killing our medical care system.”

Buxton is one of eight U.S. scientists to receive a three-year, $300,000 grant from the March of Dimes to fund his research into developing a way to predict and prevent premature births.

Preterm labor and premature birth affect one in every eight children born in the United States, Buxton said.

"It is an essential job of academia to bring new results to light on preventing premature births," he said. "That is our goal over the next three years with this study.”

Although the specific causes of spontaneous preterm labor and delivery are largely unknown, research indicates multiple factors are at play, including a family history of premature births, race or ethnicity, a pre-existing medical condition and drinking alcohol or smoking during pregnancy.

There are no drugs or medical tests known to predict or prevent premature births.

According to the March of Dimes, premature birth gives a baby less time to develop and mature in mothers, resulting in an increased risk of medical and developmental problems.

The rate of premature birth has grown by more than 30 percent in the past 20 years in the United States.

From 1994 to 2004, the rate of infants born preterm in Nevada increased more than 12 percent, according to March of Dimes statistics. It is estimated that more than 200 babies die each year in Nevada because they were born too soon.

If parents can’t afford the care or an insurance provider doesn’t pay, hospitals often get stuck with the bill.

Shayden’s mother, Ronisha Stubblefield, said her son’s premature birth came as a surprise and was a result of a condition physicians could not explain. Shayden was released from Valley Hospital Medical Center on March 19, three months after he was born.

Stubblefield said she’s anticipating medical bills for Shayden to reach $1 million. She bases that on the experience of a friend whose child was born prematurely and spent six months in a hospital, racking up more than $1 million in costs.

"I have insurance, but I don’t know how much I’m going to have to pay. I’m preparing for about $50,000,” she said. "I’ve received insurance statements ranging from $28 to $5,000, but I haven’t received any hospital bills yet. Those are going to be large and should be here shortly.”

Gretchen Papez, a spokeswoman for Valley Hospital, said she couldn’t comment on Shayden’s medical care or bills but said that "we have had million dollar babies.”

She said the cost incurred by preemies is the direct result of the kind of care they need to keep them alive and developing normally.

"Generally speaking, the smaller the baby, the more expensive it will be because of the technically advanced care, medications and longer hospital stay,” Papez said. "Combined hospital and physician costs can run into tens, sometimes hundreds of thousands of dollars.”

Additionally, these babies require specially trained nurses for 24-hour care, respiratory therapists, radiologists, medical specialists and support staff.

Buxton, whose research focuses on how certain abnormalities of potassium balance in uterine muscle cells may lead to preterm contractions and delivery, began his study three weeks ago in Las Vegas and Reno.

He said potassium in the uterine wall helps control muscle contraction during labor.

Buxton believes there may be a malfunction in a gene that delivers potassium to the uterine wall that may be linked to preterm labor. If this is true, it might provide scientists with a better understanding of why women go into preterm labor, he said.

"Of all the things we know about the human body, we know the least about the uterus. It is a true black box in medicine,” he said.

To date, Buxton has enrolled five women from Las Vegas and two from Reno for his study.

The women delivered babies by Caesarean section and agreed to provide to Buxton uterine wall tissue samples. The volunteers include a woman who gave birth at term normally and two who delivered prematurely.

Buxton said he will search for alterations in the genetic code that may be correlated with preterm delivery.

"If you knew what was causing women to go into preterm labor," he said, "you could help other women before they become pregnant anticipate the problem and provide extra care."