A Time to Focus on Premature Births

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Most families spent last week with loved ones, sharing memories and making new ones. But an increasing number of new parents spent Thanksgiving at the hospital with their premature babies.

In the US, nearly one in 10 babies are born before 37 weeks. Our preterm birth rates are worse than many countries including Rwanda, Brazil, and Lebanon. In recognition of this November’s National Prematurity Month, the March of Dimes recently released their 2018 Premature Birth Report Cards, which show rates of preterm birth across the U.S. These latest numbers are reason for added concern as the frequency of preterm birth has been increasing for the past three years.

The effects of prematurity can last long after a newborn leaves the hospital. Many critical body systems fully develop in the last few weeks of pregnancy, including respiratory, nervous, and sensory systems. Babies born before 37 weeks may experience difficulty breathing, developmental delays, vision and hearing problems, and struggles eating.  Health issues, in addition to the stress of a new baby, add to the emotional and financial strain on parents and families. One of the longest-running studies on preterm children indicates that children born prematurely had poorer health outcomes even as late as the age of 17 compared to their counterparts born full term.

Despite this compelling data, maternal and child advocates anxiously wait for the Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act to move through the House of Representatives, with anticipation of the president signing before the end of the year.

The original PREEMIE Act of 2006 focused on decreasing the number of preterm births and lessening the negative health outcome of babies born too early. The current legislation aims to establish a group, through the Department of Health and Human Services, to coordinate federal programs dedicated to prematurity, infant mortality, and other negative birth outcomes, while maintaining current programming at the Center for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA).

The fact that rates declined from 2007 to 2014 indicates that some programs and interventions are working, specifically those focused on reducing teen pregnancy. Programs that succeed in getting pregnant women into prenatal care as soon as possible and those aimed at reducing tobacco, alcohol, and substance use will also increase full-term pregnancies. Additionally, studies have shown success in improving birth outcomes with group prenatal care and incorporating community health workers in pregnancy care. These models need further investigation and, when appropriate, should be scaled to reach the most vulnerable communities.

This year, numerous reports have been produced highlighting maternal mortality, postpartum depression, and the decline of simple access to care during pregnancy. While these issues are important, maternal and infant health also require attention. We must ensure that these issues are not pitted against one another, but are all facets of a single discussion. They are part of the same story involving a lack of priorities and programs addressing the needs of pregnant women and children in this country. With the new Congress and anticipation of bills addressing maternity and child health, it is critical that the increasing rate of prematurity be approached as a complementary health issue and that specific strategies and interventions are developed accordingly.

With over a decade of experience working with mothers, infants, and their families, I often hear how difficult the holidays are due to time spent in the hospital with a sick infant. There is still opportunity this year to make a difference in the lives of families facing an uncertain future due to prematurity. With the increasing rates of preterm birth, the time is now to steer outcomes for babies and their families in the right direction.  

Natasha F. Bonhomme is the President and Founder of Expecting Health, a national nonprofit focusing on maternal and child health.

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