Neonatologists Urge Prenatal Care to Help Prevent Prematurity
November is Prematurity Awareness Month, and according to the March of Dimes, prematurity is the leading cause of death for newborn children in the United States.
“Even though there are still questions about the cause of some premature births, researchers and physicians do know that some women are at a higher risk,” says Sonia Hulman, M.D., chief of the Division of Neonatology at Crozer-Chester Medical Center. “Some of those women include: a mother who has a pre-existing medical condition, such as hypertension and diabetes, a mother who is under the age of 18 and over the age of 35, a mother who receives little or no prenatal care, and a mother with a multiple gestations (meaning twins, triplets or greater).”
Women who have had a previous premature birth or certain uterine malformations may be at an increased risk of having a premature birth. Fetuses with chromosomal abnormalities may also be more likely to be born premature.
There are several levels of preterm births, according to the March of Dimes. Those levels include: preterm or premature infant (infant born before 37 completed weeks of gestation); late preterm infant (infant born between 34 and 36 weeks gestation); moderately preterm infant (infant born between 32 and 36 completed weeks of gestation); and very preterm infant (infant born before 32 completed weeks of gestation).
“The first step to prevent premature delivery is to receive early and regular prenatal care,” says Stephen Higgins, M.D., chief of the Section of Neonatology at Delaware County Memorial Hospital. “The obstetrician may refer you to a perinatologist for special monitoring. We are lucky here at Crozer-Keystone to have a fantastic perinatologist, Carolyn Hadley, M.D., who will work closely with the obstetricians to minimize your risk of preterm delivery.”
According to the March of Dimes, researchers continue to develop new tests for identifying women who will deliver prematurely. Many of the new tests measure biological markers associated with the various routes that lead to premature delivery, such as the stress-related hormone, CRH, or various immune and clotting factors.
“If preterm labor is identified early enough, measures can be taken in many cases to stop the labor and prevent the preterm delivery,” Hulman says. “If a woman is in preterm labor, the obstetrician may give the mother a steroid called betamethasone. If the betamethasone is given in time, the medication may decrease the severity of respiratory distress syndrome (RDS), a problem related to the immaturity of the lungs, along with decreasing the risk of several other problems. The obstetrician may also treat the mother with magnesium sulphate, which may improve the neurodevelopmental outcome of the baby.”
Higgins, whose wife had some discomfort during her 26th week of labor, brought his wife in to see her obstetrician and found out that she was actually in preterm labor.
“Fortunately, we caught it in time and my wife was placed on bed rest,” Higgins says. “She was able to hold off until 36 weeks, which is considered late preterm. Because we decided to see our doctor as soon as my wife started having some discomfort, we avoided all of the problems that our son would have had if he was delivered at 26 weeks. He's a healthy 20-year-old now!”
Premature babies face serious complications, such as these:
- Respiratory distress syndrome: A serious breathing problem that affects mainly babies born before 34 weeks of pregnancy.
- Bleeding in the brain: Most common in babies born before 32 weeks of pregnancy. Bleeding in the brain is called intraventricular hemmorhage (IVH). It can cause pressure in the brain and brain damage.
- Patent ductus arteriosus: A heart problem that is common in premature babies. Untreated, it can lead to heart failure.
- Necrotizing enterocolitis (NEC): A potentially dangerous intestinal problem.
- Retinopathy of prematurity (ROP): An eye problem that occurs mainly in babies born before 32 weeks of pregnancy. In severe cases, treatment is needed to help prevent vision loss.
The March of Dimes National Prematurity Campaign seeks to address the increasing rate of prematurity by raising awareness and funding more research to identify the causes of premature birth. The March of Dimes created an educational public service advertising campaign entitled “I Want My 9 Months,” which urges women to take action before pregnancy by talking to their healthcare provider to assess their risk for having a premature baby.
Every year, more newborn babies are welcomed into the world by the caring professionals at Crozer-Chester Medical Center and Delaware County Memorial Hospital than by any other health system in Delaware County.
To learn more about your risk for preterm delivery, or to schedule an appointment with a Crozer-Keystone physician or midwife, call 1-800-CK-HEALTH (1-800-254-3258). You may also visit http://4Ubaby.crozer.org for more information or to view interactive guides to maternity care.