From Deseret News archives:

Neonatal experts oppose elective preterm inductions

Hotline pair says going 39 weeks is healthiest for babies

Published: Saturday, Nov. 8, 2008 12:19 a.m. MST
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About one-third of premature births are induced, and there's not always a valid reason — either a problem with the fetus or with mom. Increasingly, women and doctors are opting for elective inductions to fit childbirth better into personal schedules.

Barring a medical reason, birth should not be induced before 39 weeks, according to neonatal experts who will answer questions on prematurity and its prevention during today's Deseret News/Intermountain Healthcare Hotline.

From 10 a.m. to noon, Dr. Sean Esplin, associate professor in the Division of Maternal-Fetal Medicine at the University of Utah and a maternal-fetal expert at both Intermountain Medical Center and the U., and registered nurse Katrina Jensen, a case manager with SelectHealth Healthy Beginnings, will take phoned in questions. The number is 1-800-925-8177. Calls are confidential. You can also submit questions online to hotline@desnews.com.

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"There's a lot of pressure from consumers to schedule babies. The fact is that this is a business and a pretty booming one," Jensen said. But research has clearly shown doctors need to hold the line and not agree to an elective induction before 39 weeks, she said. Sometimes, women who are tired of being pregnant are pretty insistent, until they understand that time at the end of a pregnancy is the baby's very good friend, allowing crucial lung and brain development.

Esplin said of babies electively induced at 37 weeks, 8.9 percent go to the newborn intensive care unit. At 38 weeks, NICU admission is 4.5 percent. At 39 weeks, the minimal time outlined in the American College of Obstetrics and Gynecology guidelines, the number of babies who end up needing intensive care drops to 3 percent. At that point, basically full term, the rate of lung immaturity is less than half a percent.

Besides the value of waiting at the end of pregnancy for lung and brain development, it also reduces the need for C-sections. And while delivery by Caesarian section is sometimes the only option and is generally a very common and safe operation, it does carry a higher risk of infection and potential for a blood transfusion.

An increase in the number of multiple gestations — more twins and triplets —also accounts for some of the increase in preterm births. Half of twins are born before 37 weeks, and avoiding multiple births is an important way to reduce the rate of preterm birth, with their potential complications and costs, Esplin said.


E-mail: Lois@desnews.com

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