Risks of prematurity can be deadly

Prematurity kills infants about twice as often as had been thought, according to researchers at the Centers for Disease Control and Prevention. Their analysis would make premature birth the leading if not always obvious underlying cause of premature infant death, ahead of birth defects, until now considered No. 1.

The findings, published Monday in Pediatrics, the journal of the American Academy of Pediatrics, lend extra urgency to the need for pregnant women to do what they can to reduce the risk of giving birth too soon, said Stephen McDonald, director of program services for the March of Dimes Utah Chapter.

"What this study brings out is that the concept of prematurity is serious," he said. And there are proven things women can do to decrease the risk of giving birth too soon.

In an average week, 100 Utah babies are born preterm, defined as born before 37 completed weeks of gestation, McDonald said. Thirteen of those are "very preterm," born before 32 weeks. Still, Utah fares slightly better than the national average, 1 in 10 births preterm compared to the national 1 in 8.

Using linked birth/death data on 27,970 infants in 2002, the CDC concluded that premature birth was a direct factor more than 34.3 percent of the time when an infant died before age 1. Previous estimates blamed prematurity for 17 percent of deaths. In 95 percent of the deaths, the infant was very premature, born before 32 weeks gestation. Two-thirds of them died in the first 24 hours after birth.

The analysis was prompted by a discrepancy in data. The National Center for Health Statistics in 2002 listed short gestation and low birthweight as the cause of 17 percent of infant deaths, but two-thirds of the infants who died that year were born prematurely.

So the CDC researchers reviewed the cause of death and found conditions such as respiratory distress syndrome, common with premature babies, was the cause of death but was not linked back to its underlying cause, prematurity. Making those links showed the toll prematurity takes.

The March of Dimes says that more than a half million babies are born too soon each year, and the preterm birth rate his climbed more than 30 percent in the past 25 years. Among lifelong challenges of prematurity are cerebral palsy, mental retardation, chronic lung disease, visions and hearing loss and other developmental problems, the organization said.

Women can reduce risk of premature birth even before they're pregnant by scheduling a preconception visit with their healthcare provider. "If there are chronic health conditions, get those under control," McDonald said.