About one in 10 of Utah's births nearly 5,300 a year happen too early, the baby born for various reasons before 37 weeks. About half of those preemies are "not significantly premature," and comparatively few of them probably 300 or 400 are way-early, extremely low-birthweight babies.
But the reality is that losing even one week of that crucial prenatal time in the womb increases the chance of health problems and even death, according to a neonatal nurse practitioner at Intermountain Medical Center, LDS Hospital and Primary Children's Medical Center.
"Anything we can do to educate moms about things that might increase the risk of prematurity, even those close to term, will ultimately translate into reduced mortality and healthier babies," says the nurse practitioner, Tracy Karp, one of two featured experts on today's Deseret News/Intermountain Healthcare Hotline.
Karp and pediatrician Dr. Peter Lindgren will take phoned-in questions about kids' health issues from 10 a.m. to noon. They'll also answer selected questions submitted by e-mail. The number to call is 1-800-925-8177; the e-mail address is firstname.lastname@example.org. Questions about the health of all kids, from womb age to dorm age, are welcome.
Even being slightly premature increases the risk a baby will need intensive care. It can bring feeding problems and greater likelihood of jaundice. There are developmental disabilities and other health issues associated with prematurity. It is the leading cause of birth defects.
There's no way to guarantee that a baby will be carried the full 40 weeks. But there are things that are associated with increased risk of prematurity, Karp says, including teen pregnancy, smoking, drug use and multiple births (twins and triplets are always premature to some degree). And speaking of twins, the number has increased in recent years, so that twins now represent about 3 to 4 percent of all live births, he says.
Other factors also can trigger prematurity, including urinary tract and other infections, he says. Mothers who were themselves born early are also more apt to deliver babies early. Not getting prenatal care is a significant risk factor, Karp says. And certain ethnic backgrounds make a difference; Pacific Islanders and Asians are less apt to have a baby prematurely, while African-Americans and Hispanics are more likely to.
Weight alone is not a good indicator of maturity, Karp says. Preemies can weigh as much as full-term babies, but have problems associated with prematurity. Utah health providers, by the way, are beginning to use Utah-centric growth charts, because Utah babies tend to be bigger than the average U.S. baby. "We just grow them big," Karp says.
Dramatic strides have been made in terms of survival. The majority of children born even two to three months early now survive, although that doesn't mean they escape all the problems associated with prematurity. There's a big jump in outcomes between 36 and 37 weeks' gestation.Preterm births cost at least $26 billion a year in the United States, including health costs.