For Immediate Release
May 25, 2010

KDHE Office of Communications
communications@kdheks.gov, 785-296-0461

Born at the Right Time: The Urgent Need to Prevent Prematurity

An Op-Ed Column by Jason Eberhart-Phillips, MD
Kansas State Health Officer

Life is hard when you’re born too young.

Babies born before they’ve had a full nine months to mature in their mother’s womb face a staggering array of medical complications and life-threatening risks. For many, life is a struggle for survival from the moment they are born.

Because their lungs are not fully developed, premature newborns often have serious breathing problems. They also have a higher risk of jaundice, troubles with temperature stability and feeding difficulties.

Even those born just a little too early – between 34 and 36 weeks of gestation as compared to the full term of pregnancy of 37 weeks or more – are vulnerable to serious complications. These so-called “late preterm” babies are much more likely to require intensive medical care in their first days of life, and they are six times as likely to die in their first week as babies who are born full-term.

Sadly, the troubles these children face don’t end when they grow out of infancy.

By the time they reach school age, late preterm children are 36 percent more likely to have developmental delays or disabilities, according to one large study. They also have an increased risk of bad behavior and learning problems in school.

For these reasons alone, the problem of prematurity should be a concern to everyone who cares about giving the next generation a fair start in life. But prematurity is also a huge burden on our economy, and is a significant cause of our spiraling health care costs.

The immediate medical care of premature infants is costing parents, taxpayers and everyone else who buys health insurance about $26 billion per year, or $50,000 per kid. That’s more than 10 times the cost of bringing a full-term baby into the world.

The burden of prematurity is higher in the United States than in any other developed country, and until recently it was only getting worse. Since 1990, the late preterm birth rate has increased more than 20 percent in this country, to approximately one in 12 births. That rate has dropped very slightly in the last two years, but it remains the number-one obstetrical challenge in America.

In Kansas, approximately 3,900 babies are born premature each year, two-thirds of whom are born late preterm, between 34 and 36 weeks. Of the 300 babies in the state who die each year before their first birthday, more than 60 percent are premature.

The reasons for the growing problem of prematurity are many and complex. Some factors may not be controllable, such as the advancing average age of mothers and the risk of multiple births that comes with the growing use of artificial reproductive technology.

But there are many potentially modifiable factors that are thought to increase risk, factors related to a mother’s overall health, education, social status and access to appropriate prenatal health care. These factors are calling out for a concerted effort in each Kansas community to lessen the burden of prematurity.

Recently two big changes in the Kansas landscape offer hope that we can begin to reduce our state’s premature birth rates significantly in the next few years.

One change is the passage of a new statute in the Kansas Legislature this year that enables researchers to conduct intensive interviews of a random sample of new mothers across the state. Analysis of the data generated from these interviews will help public health agencies at the state and local levels target the factors that contribute most to the preterm birth problem in Kansas.

The other exciting new development is a free service for pregnant women and mothers of infants under 1 year of age called Text4Baby. Women who simply text the word “BABY” to 511411 (or “BEBE” in Spanish) will receive three text messages per week with helpful, medically sound information timed to their delivery dates or the birth dates of their children.

Text4Baby, which is a national collaboration between public health agencies and private companies, aims to reach mothers at high risk for preterm birth with information on how to stay healthy in the one place they nearly all have access: their cell phones. Because virtually all wireless providers are participating in Text4Baby, it costs mothers nothing to receive the texts, even if they don’t have a texting plan on their cell phone accounts.

Since Text4Baby began in February, about 40,000 women have signed up, including more than 600 in Kansas.

The new state law and the texting program are important first steps, but much work remains in reducing prematurity and its attendant costs. It will take more than the health care sector to solve this problem. It will take a groundswell of public support, a commitment of caring people in every walk of life to work together to make life a little easier for the tiniest of Kansans.

Every week that we can keep a developing infant safe in its mother’s womb, until the right time for birth arrives, improves another child’s chances for a healthy and rewarding life. Every added week in the womb ensures a brighter future for Kansas.

Dr. Eberhart-Phillips is the Kansas State Health Officer and Director of Health in the Kansas Department of Health and Environment. He can be reached at jeberhart-phillips@kdheks.gov. Previous columns are now available online at Dr. Jason’s Blog, www.kdheks.gov/blogs/dr_jasons_blogs.htm.