Recent federal statistics show that America’s pre-term birth rate declined for the sixth year in a row but remains higher than any industrialized nation in the world. America tops the list of pre-term birth rates with 11.5 percent of all babies born pre-term ( less than 37 weeks) in 2012. One in every eight (or half a million) babies are born pre-term in America each year.
CDC official Dr. Eve Lackritz, M.D., testified before a U.S. Senate subcommittee several years ago regarding America’s pre-term birth “epidemic.” Lackritz reported that pre-term birth is a leading cause of infant mortality and long term disabilities. She also described the emotional and financial distress experienced by families.
Maine reported the second highest pre-term birth rate increase in the nation between 1992 and 2002. The rate increased 36 percent, soaring from 7.5 to 10.1 percent. Then it soared even higher to 11.1 percent in 2006 before beginning to decline.
Maine was one of three New England states receiving a March of Dimes award last year because its pre-term birth rate dropped to 9.2 percent. However, Maine’s rate has never returned to the pre-surge 7.5 percent. One in every 10 babies is born pre-term in Maine.
That’s about 1,500 babies each year.
No single cause is cited as the reason for the pre-term birth epidemic afflicting America. Risk factors include uterine/cervical abnormalities, hypertension, diabetes, smoking, illegal drug use, and multifetal pregnancies.
March of Dimes cites lack of universal health coverage as a major contributing factor. The Eastern Maine Medical Center Chief of Pediatrics and Director of Neonatal Intensive Care, Dr. Mark Brown, commented that, “In the past, health care was considered to be a privilege, but today it’s considered to be a right.” Brown agreed that prenatal care affects pregnancy outcomes, but said that women receiving prenatal care also experience pre-term births.
A 24-year old Aroostook mother was surprised last month when informed that the sac of amniotic fluid surrounding her 30-week unborn baby was leaking. She was healthy and had received prenatal care.
“I thought my baby would be full term,” said Jenny.
Instead, Jenny’s physician ordered a steroid shot to help develop the baby’s lungs. Then Jenny was transported by ambulance to EMMC (three hours away), where she received another steroid shot and medication to delay birth. Her 3-pound, 2-ounce son was born five days later.
Brown said it’s better if pre-term babies are born at hospitals with a Level III nursery staffed by trained personnel and technology needed to support pre-term babies until they mature.
“It’s better if they’re born at those hospitals than being transported afterwards,” said Brown, who explained that most pre-term babies’ lungs and other organs are not sufficiently developed to function on their own.
Jenny said that it was difficult not being able to hold her baby immediately after birth because he needed to stay in an isolette.
“I can’t wait to get him home,” she said.
The baby’s father, Jake, said it was unnerving to see his son hooked up to so many tubes, but he got used to it.
Brown said that pre-term survival rates and outcomes have improved because of surfactant (which lubricates babies’ lungs), antenatal steroids, and improved technology. He said that EMMC treats babies born at 23 weeks or younger, though he said not all 23-weekers do well. He said the hospital has treated some 22-weekers, at parents’ request, but survival rates for that age are very low.
“We use the calculator on the NICHD [National Institute of Child Development] website to calculate survival rates, and that’s the information we present to parents when discussing treatment options,” Brown said.