Doctors are trying to reduce the number of preterm births

For Doctor's to reduce the number of pre-term birth's, all OBGYN's treating pregnant mother's need to make the mother is aware of the complication's she suffer's in her pregnancy and treat these complication's accordingly. There is more chance for a mother to deliver a pre-term baby when complications are left untreated. Anemia, hyper or hypothyroidism, hyperemesis-graviderum, diabetes and when a fetus is placenta-previa, left untreated, can all cause a baby to be born early, not to mention cause death in both mother and child.
unhappygrammy

Sunday, July 25, 2010
Doctors are trying to reduce the number of preterm births


MORE INFORMATION
For more information on preterm delivery from the March of Dimes, visit www.marchofdimes.com/pnhec/188_1080.asp.
Although the relative numbers of babies born early in the United States is down slightly for the first time in decades, more than half a million infants are still born before 37 weeks of gestation.
Preterm birth is a leading cause of infant death, and babies who survive an early birth often face a lifetime of health problems, including breathing problems, cerebral palsy, blindness, and learning and developmental disabilities.
Preterm births are estimated to cost the nation’s health care system as much as $26 billion a year.
Yet, there’s poor understanding about the causes of preterm birth – labeled “complex” by a committee set up by the Institute of Medicine to examine causes and possible prevention routes.
One frequent suspect, although not definitively linked in research, is the tendency for obstetrician-gynecologists to induce labor or perform cesarean sections at around 34-36 weeks’ gestation, according to a 2009 report by the National Center for Vital Statistics.
The 4 percent decline in preterm birth rates from 2006-08 – to 12.3 percent of all live births, regardless of delivery method – suggests to some researchers that doctors are doing a somewhat better job of estimating gestational age before an intervention.
But there are a host of other possible contributors to early births, from neighborhood and environmental exposures to infertility treatment and genetics.
A recent survey of nearly 800 women done by the March of Dimes and BabyCenter.com, a pregnancy and parenting website, found that only one in four new or expectant mothers had discussed preterm birth with their doctor before their second trimester.
And even though having delivered early before is one of the top risk factors for another preterm birth, 40 percent of women who reported a prior early delivery said they weren’t aware of their heightened risk.
The study also interviewed 225 ob-gyns. Their majority view – 83 percent – was there are few steps that have been shown to prevent preterm labor – avoiding tobacco and drug use, managing high blood pressure or diabetes and getting regular prenatal care – and that since all these are part of good regular pregnancy care anyway, there’s little point in raising the subject.
More than half said they felt such a discussion would raise undue fear or worry for an expectant mom.
But there is growing evidence that points to specific problems with infection, inflammation and hormonal imbalances tied to the immune system in triggering early labor.
A number of dental researchers have found that periodontal (gum) disease can increase by as much as seven times the risk of preterm or low birth weight delivery for women.
Scientists at the National Institute of Child Health and Human Development have found that as many as one in three preterm babies are born to moms who have an infection in their amniotic fluid that is silent – that is, it doesn’t cause any outward sign or symptom.
Last winter, Dr. Roberto Romero and his team at the NICHD’s perinatology research branch reported they had found DNA variants in mothers and fetuses that appear to raise the odds of preterm labor and delivery. Romero speculates that the DNA variants regulate the intensity of immune response in both mother and baby, normally set to a standoff that allows pregnancy to continue.
But those same hormones also play a role in inducing labor, and the researchers think the genetic quirks they’ve seen may ramp up this process and result in premature labor in response to a level of infection that other mothers and infants without the variant are able to ignore and progress to full term.
Lee Bowman is health and science reporter for Scripps Howard News Service. He can be reached at bowmanl@shns.com.

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