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Patrick Fiero, M.D.

Patrick Fiero, M.D. Obstetrician/Gynecologist

Prematurity Threatens the Health of Babies at Birth and for a Lifetime

It's difficult to imagine a baby born so tiny that its body fits snugly in a mother's cupped hands. But that is just what you'll see when looking at a baby that is born premature.

"Welcoming a new baby is one of the most joyous celebrations a family experiences, but many new parents are faced with their worst nightmares when prematurity, or preterm birth, occurs. In the U.S. alone, more than 28,500 babies died in 2006 before they were a year old and more than 36 percent of those infant deaths are from babies who died before the critical 37-week gestational period," explains Donna Wood, Practice Leader of Clinical Operations at Quorum Health Resources (QHR). "Prematurity is currently the leading cause of newborn deaths."

The March of Dimes is an organization dedicated to spreading the word and encouraging research with its national awareness campaign through "Prematurity Awareness Month" in November and "World Prematurity Day" on November 17.

Even with national recognition and medical advances, two worrisome facts remain: experts do not have exact causes for why some babies are born before the full 40-week term and the prematurity rate continues to rise. The Center for Disease Control and Prevention (CDC) reports that in the U.S. alone the premature birth rate is higher than it has been in the past two decades.

While prematurity prevention is still somewhat unknown, medical experts have made tremendous advances in the care of premature babies that are born. Even the tiniest preemie now has a chance of survival. The 2008 March of Dimes National Ambassador, Catharine Aboulhouda, is an example of the miraculous work being done in Neonatal Intensive Care Units (NICUs). Catharine was born 16 weeks early and weighed just 1 pound, 10 ounces and measured only 12 inches long. With an endless list of medical issues including tiny lungs, heart defects, bleeding in the brain and jaundice, baby Catharine spent an entire113 days in the NICU. At the end of her 113 day hospital stay, Catharine finally got to go home with her parents, and amazingly had no lifelong illnesses.

In addition to the initial health risks associated with a premature birth, the CDC has also identified many other lifelong health issues that can occur in babies born before a full term pregnancy. Long-term issues can include: intellectual disabilities, cerebral palsy, impaired vision and hearing and breathing, feeding and digestion problems.

"Premature birth can lead to lifelong medical problems and disability for the child," says Obstetrician/Gynecologist Patrick Fiero, M.D. of J.C. Blair Medical Services, Inc. "It also requires costly interventions and hospitalization that can last for weeks or months. The stress prematurity causes all family members, both emotionally and financially, can be overwhelming."

When doctors suspect that prematurity may occur, doctors often use the Fetal fibronectin test (also known as fFN), to help predict the risk of a premature delivery. Being able to identify the likeliness of preterm labor allows doctors to identify if premature birth preventative methods should be used. These methods may include:
Bed rest- used to calm maternal stress that may stimulate rapid hormone production
Prenatal corticosteroids or tocolytic medications- labor-suppressing drugs used to slow labor contractions

Researchers are also working to detect the genes that may increase the risk of premature labor and are developing tests to measure biological markers associated with the hormones and other factors that may cause preterm labor.

The key factor in preventing prematurity, according to MedlinePlus, is to begin prenatal care early on and throughout the pregnancy. The CDC identified ways that moms-to-be can prepare for the healthiest pregnancy possible:

Take a 400 micrograms folic acid vitamin every day
Do not use alcohol, tobacco or drugs
Keep hands clean by washing often to prevent infections
Schedule regular prenatal care to monitor your health and your baby's health
Eat foods from each of the five food groups each day
Avoid raw or undercooked meat and caffeine

Statistics also show that African-American women are more likely to experience preterm labor. Other groups at higher risk are women younger than 16 or older than 35, of low socioeconomic status, and those who use tobacco or illicit drugs.

"The best way to protect yourself and your baby is to have excellent prenatal care throughout your pregnancy, and be aware of any factors that would put your baby at greater risk for prematurity," says Fiero. "With more research focusing on this serious complication for newborns, medical science may soon have better answers for why the problem occurs and treatments to prevent it."

For more information about the March of Dimes Prematurity Campaign, go to http://www.marchofdimes.com/mission/prematurity.html

This article is provided courtesy of J.C. Blair Health System and Quorum Health Resources.