Wednesday, June 18th, 2014
The number of women who are having labor medically induced before their due dates is on the decline, according to a report from the Centers for Disease Control and Prevention–good news for the health of babies who may face risks if born prematurely. The rate of premature Cesarean sections is also falling, the CDC found. More from US News:
Rates of induced labor declined across the board since 2006 for expectant mothers at 35 to 38 weeks of gestation, with the greatest decline at 38 weeks, researchers with the CDC’s National Center for Health Statistics (NCHS) found.
This is good news for the health of these babies, who can face serious health problems when delivered preterm, said Dr. Edward McCabe, chief medical officer for the March of Dimes.
Babies born early are 1.5 to two times more likely to die during their first year of life, compared to babies delivered following a full term of 39 weeks or more, he said.
“There’s this feeling that we’ve done so well with our premature babies, we’ve been seduced by the advances and think it’s safe to induce delivery early,” McCabe said. “We’ve ignored the fact that there are significant risks of illness and death in late preterm and early term babies.”
The largest decline in induced labor occurred for early term births at 37 to 38 weeks, which fell 12 percent between 2006 and 2012, the CDC reports. Late preterm births at 34 to 36 weeks of gestation declined by 4 percent.
This decrease comes at a time when medical societies are raising concerns about unnecessary early deliveries.
The rate of induced labor more than doubled between 1990 and 2010, from nearly 10 percent of births to just under 24 percent. While some of these induced births were needed to preserve the life of mother and child, many also occurred to better fit the birth into the busy schedules of the parents or the doctor, McCabe said.
The American Congress of Obstetricians and Gynecologists doesn’t recommend induced deliveries prior to 39 weeks of pregnancy without a clear medical reason.
Image: Woman in delivery room, via Shutterstock
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Monday, February 24th, 2014
Hearing adults talking may have a significant effect on the cognitive and language development of babies who were born prematurely, according to a new study published in the journal Pediatrics. More from WomenandInfants.org:
The goal of the study was to test the association of the amount of talking that a baby was exposed to at what would have been 32 and 36 weeks gestation if a baby had been born full term, using the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley – III) cognitive and language scores.It was hypothesized that preterm infants exposed to higher word counts would have higher cognitive and language scores at seven and 18 months corrected age.
“Our earlier study identified that extremely premature infants vocalize (make sounds) eight weeks before their mother’s due date and vocalize more when their mothers are present in the NICU than when they are cared for by NICU staff,” explained Dr. Vohr.
At 32 weeks and 36 weeks, staff recorded the NICU environment for 16 hours with a Language Environment Analysis (LENA) microprocessor. The adult word count, child vocalizations and “conversation turns” (words of mother or vocalizations of infant within five seconds) between mother and infant are recorded and analyzed by computer.
“The follow-up of these infants has revealed that the adult word count to which infants are exposed in the NICU at 32 and 36 weeks predicts their language and cognitive scores at 18 months. Every increase by 100 adult words per hour during the 32 week LENA recording was associated with a two point increase in the language score at 18 months,” said Dr. Vohr.
The results showed the hypothesis to be true.Dr. Vohr concluded, “Our study demonstrates the powerful impact of parents visiting and talking to their infants in the NICU on their developmental outcomes. Historically, very premature infants are at increased risk of language delay.The study now identifies an easy to implement and cost effective intervention – come talk and sing to your baby – to improve outcomes.”
Image: Mom holding infant’s hand, via Shutterstock
Keep track of your Baby’s growth with our helpful chart for girls and boys.
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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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