When it comes to its efforts to reduce its preterm birth rate, Kentucky isn’t doing so hot.
According to the March of Dimes’ 2015 premature birth report card released in early November, Kentucky scored a “D.”
“What we’re not getting better at is preventing premature birth,” said Tracy Burch, neonatal nurse manager for St. Elizabeth Healthcare. “It’s an area we need to work on.”
The report cards, which awarded the United States a “C” overall, were released earlier this month in conjunction with November as prematurity awareness month. Each year, one in 10 babies in the United States is born prematurely, according to the March of Dimes, and prematurity is the No. 1 killer of babies in the United States.
Although Kentucky and the nation have a long way to go to reduce the preterm birth rate, Burch said one area in which healthcare workers have seen great strides in helping premature babies survive.
Interventions
A baby is considered premature when he or she is born before 37 weeks gestation. In the past, Burch said, babies born before 26 weeks’ gestation had a very low survival rate, and babies had to be born at at least 23 weeks’ gestation before doctors would attempt resuscitation. Today, the survival rate has risen significantly, and the age at which doctors will sometimes attempt resuscitation has gone down to 22 weeks’ gestation, depending on how vigorous the baby is at delivery.
“We are getting better at improving the survival rates of babies born prematurely,” Burch said, “and even the survival rates of ‘micro-preemies,’ who are born at very low birth weights.”
Also, today, doctors can intervene if a woman is going into premature labor. They can give her steroids that will help a baby’s lungs mature more quickly so he or she doesn’t have as many breathing problems after birth, Burch said.
Complications
Complications from a premature birth intensify in correlation with a baby’s age and birth weight.
“There is a wide variety of problems that a premature baby can have,” Burch said. “It all depends on the gestational age. A 37-week gestation baby is going to look very different from a 32-week gestation baby.”
Babies born at an extremely low birth weight, for example, have gelatinous skin, predisposing them to infections, Burch said. They also have a hard time regulating their body temperature and usually need to be placed in an incubator. Also, their livers aren’t fully developed, leading to a higher incidence of jaundice. They have a higher incidence of brain bleeds and they often require surfactant to provide a lubricant for their lungs so they can breathe.
Risk factors
Risk factors for having a premature baby include a previous preterm delivery, any kind of infection, high blood pressure, an incompetent cervix, gestational diabetes, smoking, use of illicit drugs, a previous multiple-birth delivery, and a spacing of fewer than 12 months between pregnancies.
