Preterm births challenging

There has been a 30 percent increase in premature births in the United States since the 1980s, according to a new comprehensive study that relied, in part, on Utah data. Premature births now represent 12.5 percent of all births, which is alarming considering that preterm birth is a leading cause of death among infants and contributes to chronic and acute health care problems for surviving babies. The report considers "preterm" as a birth before 37 weeks of pregnancy.

These findings, which come from a new report from the Institute of Medicine of the National Academies, focus on the steep societal costs of premature births. The health care costs from birth to age 5 are profound, particularly among infants who require extended stays in newborn intensive care units.

Add to that the costs of ongoing and acute health-care issues and the costs of special education for infants who face developmental challenges such as mental retardation, cerebral palsy, hearing loss and vision loss. In 2005, the costs nationwide were estimated to be at least $26.2 billion — about $51,600 per infant.

In other words, steep societal challenges accompany the advances of the health-care system to care for preterm babies — infants who, if born decades ago, likely would have died. Make no mistake, these discoveries are remarkable. The challenge is recognizing the ripple effect of these births and ensuring that the systems that serve these children and their families have sufficient resources.

This research also spotlights the need to unravel why so many children are born prematurely. Some point the finger at advances in reproductive assistance, which often results in multiple births. However, this research found that multiple births represent only 10 percent of preterm births. The odds of preterm birth increase dramatically as the number of fetuses per pregnancy increase. Ethnicity appears to play a role. Just 10 percent of healthy Caucasian women deliver preterm babies compared to 15 percent for African Americans. Clearly, more research is warranted.

Our health-care system's ability to save preterm babies who would have died a decade or two ago should be celebrated. Until specific causes can be identified, the nation's health-care system, public and private medical insurance providers, social service agencies and public education systems must stay abreast of these trends and attempt to devote resources to children who will require extra assistance during their childhoods, and perhaps beyond.