Premature births called crisis in state

By JOHN CANNON
The Independent

ASHLAND November 11, 2008 10:10 pm

— Kentucky has received an “F” in the March of Dimes annual Premature Birth Report Card, and Amanda Preston, director of women’s services at King’s Daughters Medical Center, is determined to raise that grade by reducing the number of premature infants born at the local hospital by at least 15 percent.
The Women’s Health Program at KDMC is one of three Kentucky sites participating in “Healthy Babies Are Worth the Wait,” a partnership of the March of Dimes, Johnson & Johnson Pediatric Institute and the Kentucky Department for Pubic Health. The A.B. Chandler Hospital at the University of Kentucky and the Trover Health System’s Regional Medical Center of Hopkins County in Madisonville are the other two sites.
According to the report slated for release today, 15.2 percent of the births in Kentucky are premature. The national average is 12.7 percent. The March of Dimes national goal — which likely is not achievable —is to lower the premature rate to 7.6 percent by 2010.
While she does not have the exact figures on the premature birth rate at KDMC, Preston said it mirrors the statewide average, which she called “a crisis that must be dealt with.”
“Healthy Babies Are Worth Their Weight” is now in its third year at KDMC, but Preston said there still is not enough data on how effective it has been in reducing the number of premature births in Ashland. However, if the program works as well as hoped, “it could be a building block for the entire nation in preventing this type of prematurity,” she said.
Under the multidisciplinary program, a social worker meets with all pregnant women planning to have their babies at KDMC — the earlier in their pregnancy, the better, Preston said. The meetings usually take place at offices of physicians.
“The social worker meets with patients to see what steps can be taken to reduce the chances of a premature birth,” she said. “It may be drug counseling, smoking cessation, or even avoiding second-hand smoke. It varies from patient to patient.”
However, Preston said she sees the impact of premature births daily.
“Premature births can cause breathing problems, increase the risk of infections and jaundice, and even cause blindness and learning disabilities,” she said. “Many women don’t realize this, but newborn babies whose mothers smoked during pregnancy go through withdrawal for their addiction to cigarettes like adults do.”
The same problem exists for babies born to non-smoking mothers who were frequently exposed to second-hand smoke from a spouse or other close relative, she added.
Mothers who use drugs during pregnancy often give births to infants who are addicted, Preston said.
“A lot of our problems with premature births is a result of the choices we make,” she said. “Our goal is to increase the public’s knowledge of how what we do can affect the health of the baby. A lot of women just don’t know.”
Another cause of premature births is the failure of pregnant women to see a physician on a regular basis.
“Either they don’t have transportation or they don’t have insurance and think they can’t afford to visit the doctor,” Preston said. “What many women don’t realize is that there is a federal program that assures that they will receive proper prenatal care regardless of their ability to pay.”
While Kentucky’s “F” on the Premature Birth Report Card is certainly a negative, it is only slightly worse than the national as a while, which received a “D” on the report card. As bad as Kentucky’s rate is, other states have a higher rate of premature births.
Not all premature births are negative, Preston said. “Sometimes a baby being born premature is the best thing for the mother. Sometimes we need to get the baby out because of the mother’s medical condition.”
However, such premature births are the exception instead of the rule. Full-term babies typically encounter much fewer health problems.
“We’re not going to be able to get to an A overnight,” Preston said. “It is going to take a lot of education, early intervention and greater access to physicians. But we will get there. This is a problem we can solve.”
JOHN CANNON can be reached at jcannon@dailyindependent.com or at (606) 326-2649.