Monday, December 2nd, 2013
A growing number of the smallest premature babies are surviving and, in many cases, thriving–but medical issues commonly persist long after birth. More from NBC News:
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Alexis [Clarke] was born after she’d been in the womb just over 25 weeks; a typical pregnancy lasts 40 weeks. Babies born before 37 weeks are considered premature, but with medical and technological advances, it’s no longer unusual for very preterm babies to survive. The key, in general, is a steroid for mothers and a drug for their babies.
Alexis’ journey has been marked by ups and downs. Just as her parents thought she was ready to be discharged in time for Thanksgiving, one of her doctors told them she needed emergency eye surgery. Then a small cough raised concerns that she’d contracted whooping cough, prompting her to be put into isolation (tests came back clear). But an MRI of her brain delivered the good news that her development seems to be proceeding normally.
Baby Alexis is hardly the tiniest preemie born, but her journey from neonatal intensive care to home is typical of other extremely premature babies. In 2011, less than 1 percent of live births in the U.S. were considered “extremely preterm,” delivered before 28 weeks. That represents more than 28,000 babies. Meanwhile, the total number of premature births in the U.S declined last year to 450,000, or 11.5 percent, the lowest preterm birth rate in 15 years.
“In the past six years we’ve had babies survive that we didn’t think could survive,” Dr. Krishelle Marc-Aurele, one of Alexis’ doctors, told NBC San Diego.
Some hospitals are divided on treating babies born in the “gray zone,” between 23 and 25 weeks. In the U.S, up to 90 percent of neonatal units resuscitate babies born as soon as 23 weeks. Younger than that and most doctors believe a baby is not viable. “The lower level of viability is inching down,” said Dr. John Muraskas, who resuscitated the smallest surviving baby on record, Rumaisa Rahman, born in 2004 weighing 9.2 ounces.
Muraskas, a professor of pediatrics and neonatal/perinatal medicine at Loyola University Medical Center, said the key treatments began in the 1990s and have made all the difference.
Now doctors routinely give moms on the brink of delivering too soon two doses of steroids to help the baby or babies’ lungs mature quicker and strengthen the blood vessels in the brain. That reduces the risk of a premature infant developing a brain bleed.
Once born, preemies receive surfactant, a drug administered through a breathing tube into their lungs that makes them stronger and less stiff, and able to breathe independently sooner.
Tuesday, November 19th, 2013
Exposure to phthalates, a type of chemical used in certain plastics and cosmetics, has been linked in a recent study to an elevated risk that pregnant women will deliver their babies prematurely. More from Reuters:
Researchers found that women who delivered babies before 37 weeks gestation had higher levels of phthalates in their urine, compared to women who delivered their children at full term, which is 39 weeks.
“Preterm birth is a real public health problem,” said John Meeker, who led the study. “We’re not really sure how to go about preventing it, but this may shed light on environmental factors that people may want to be educated in.”
Meeker, from the University of Michigan School of Public Health in Ann Arbor, added, “We knew that exposure to phthalates was virtually ubiquitous here in the U.S. and possibly worldwide and preterm births increased for unknown reasons over the past several decades.”
Phthalates are included in products for a variety of reasons, include to make plastic flexible.
Image: Lipsticks, via Shutterstock
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Tuesday, November 19th, 2013
Women who have had bariatric surgery as a weight loss solution may face an elevated risk of some pregnancy complications, including giving birth to babies who have low birth weight and are born prematurely, a new study has found. More from The New York Times:
The authors of the research, published in BMJ, looked at roughly 15,000 births that took place in Sweden between 1992 and 2009, including about 2,500 among women who had had had weight loss surgery. On average, the women delivered about five years after the surgery.
After controlling for age, smoking and other factors that could influence pregnancy complications, the researchers found that 10 percent of children born to women who had undergone bariatric surgery were delivered prematurely, compared with 6 percent in the other group.
A similar pattern was found for low birth weight. Five percent of children born to mothers in the surgery group were small for their gestational age, compared with 3 percent in the other group.
The researchers speculate that the trends could be driven by deficiencies in vitamins and minerals, which occur after bariatric surgery and could affect fetal and placental growth.
Image: Pregnant belly, via Shutterstock
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Monday, November 18th, 2013
Boys are slightly more likely than girls to be born prematurely, a new international study on newborn health has found. Additionally, boys don’t tend to fare as well as girls world-wide. More from The Associated Press:
“This is a double whammy for boys,” said Dr. Joy Lawn of the London School of Hygiene & Tropical Medicine, who led the team of researchers. “It’s a pattern that happens all over the world.”
The gender difference isn’t large: About 55 percent of preterm births in 2010 were male, the report found. Nor is it clear exactly why it happens.
The finding comes from a series of international studies being published Friday that examine newborn health and prematurity. About 15 million babies worldwide are born too soon, most of them in Africa and parts of Asia where survival is difficult for fragile newborns. Globally, about 1 million babies die as a direct result of preterm birth and another million die of conditions for which prematurity is an added risk, the researchers calculated.
Friday’s report offers some of the first estimates of how many preemie survivors go on to suffer certain disabilities, and found that where these babies are born, and how early, determines their risk.
Overall, Lawn said about 7 percent of survivors have two of the most burdensome disabilities: neurologic-developmental impairment ranging from learning disabilities to cerebral palsy, and vision loss.
But the biggest risk is to the youngest preemies, those born before 28 weeks gestation. Worldwide, 52 percent of them are estimated to have some degree of neurodevelopmental impairment, the report found.
Moreover, the risk of impairment in middle-income countries is double that of wealthy countries like the U.S.
For example, China is saving more preemies’ lives but at the cost of their vision, Lawn said.
Middle-income countries are missing out on a lesson the U.S. learned the hard way several decades ago, that giving these tiny babies too much oxygen can trigger a potentially blinding condition called retinopathy of prematurity.
“Disability is not something that’s inevitable. It’s preventable,” she said, calling for improved quality of care including eye checks to prevent or reduce vision loss.
The March of Dimes reported this month that 11.5 percent of U.S. births now are preterm. That rate is inching down, thanks mostly to fewer babies being born just a few weeks early as standards for elective deliveries have tightened, but it still is higher than in similar countries.
Image: Newborn baby, via Shutterstock
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Monday, October 21st, 2013
The number of women who become pregnant using donor eggs has risen in the last decade, although the number of healthy babies born on time and at a healthy weight remains less than ideal for that group. More from The Associated Press:
That ideal result occurred in about 1 out of 4 donor egg pregnancies in 2010, up from 19 percent a decade earlier, the study found.
Almost 56 percent resulted in a live birth in 2010, and though most of these were generally healthy babies, 37 percent were twins and many were born prematurely, at low birth weights. Less than 1 percent were triplets. Low birth weights are less than about 5½ pounds and babies born that small are at risk for complications including breathing problems, jaundice, feeding difficulties and eye problems.
For women who use in vitro fertilization and their own eggs, the live-birth rate varies by age and is highest — about 40 percent — among women younger than 35.
Women who use IVF with donor eggs are usually older and don’t have viable eggs of their own. Because the donor eggs are from young, healthy women, they have a good chance of success, generally regardless of the recipient’s age.
The average age of women using donor eggs was 41 in 2010 and donors were aged 28 on average; those didn’t change over 10 years.
The study, by researchers at Emory University and the federal Centers for Disease Control and Prevention, was published online Thursday in the Journal of the American Medical Association and presented at the American Society for Reproductive Medicine’s annual meeting in Boston.
Image: Pregnant woman, via Shutterstock
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