<p>THis just stuns me.
really
My oldest as I have mentioned ( and mentioned) before, was born at 30 weeks SGA, and was amazingly healthy,- * for a premie*
Once you got past the surgery that brought her down to 1lb 9 oz, her intercranial hemmorages, and the respirator and transfusions.</p>
<p>She does have some issues that are related to prematurity, that will never go away. Not serious yet, but I think most parents, want their kids to be as healthy as they can be throughout their lifespan, not just at birth.</p>
<p>When she was born, 24 years ago, they were working on reducing premature births. There were promising developments in keeping babies inside longer, as well as producing artificial surfactant ( for the lungs) and improved heart surgery techiniques.
There was every indication that premature birth, would go * down* in the decades to follow, not * up*</p>
<p>We used to be very involved in the parents of prematures support organization. But D was by far doing the best of any child there, and while these other parents, knew what I had gone through in a way, my friends and relatives did not, I felt cruel bringing her to events when other children were blind from room aid oxygen, had CP, were the only remaining twin or triplet, or were even still on oxygen.</p>
<p>How well she has done, is unusual at best.
The problems high risk kids have impact the health care system, the educational system in a way that we haven’t been prepared to meet, at least from my viewpoint.
THis article states that the increased numbers of pregnancies made possible by fertility drugs account for a good portion of premature births.
If this is true- I am concerned, that the numbers of impacted children and families will continue to rise.
<a href=“http://seattlepi.nwsource.com/health/1500AP_Preemie_Drug.html[/url]”>http://seattlepi.nwsource.com/health/1500AP_Preemie_Drug.html</a></p>
<p>I suspect there are four things at work: (1) older mothers, (2) fertility treatments, (3) better ability to anticipate and to prevent the types of premature births that get counted as “miscarriages,” not births, and (4) fewer abortions. </p>
<p>My wife was a Maternal and Infant Health public health official for a number of years. There was a big drive on to reduce infant mortality, although the rate was very small, around 9-12 per thousand, depending on where you were. She used to say that if you really wanted to reduce the infant mortality numbers, the things that would make the most significant impact, statistically, would be prohibiting first pregnancies for women over 30 (much higher risk levels), making abortions more readily available to women in their 20s and older (a fair number of difficult births were women essentially trying to abort themselves late term), and encouraging teenage pregnancy rather than trying to prevent it (teenagers tended to have healthy babies, regardless of lifestyle, so the denominator would go up). Of course, that’s not what anyone really meant by lowering infant mortality, so they just spent a lot of money on more and better prenatal care, which had a small effect on the actual mortality rate (but probably good effects on lots of other things).</p>
<p>It was also clear that, as technology improved, many more events were getting classified as live births rather than miscarriages, and doctors were more aggressive about trying to prevent miscarriages because holding the line for a few days might produce a live birth with a fighting chance.</p>
<p>Miscarriage is the loss of a pregnancy before 20 weeks.
I doubt that many preterm births are viable before 20 weeks. ( Ihaven’t heard of any)
I would also assume, although I certainly havent checked, that a birth would mean a live infant, and for preterm births to increase, that means the number of live births before 36 & after 20 weeks SGA have increased</p>
<p>I would agree with reducing numbers of pregnancies both on the young end ( what I saw- teens did not have healthy pregnancies, because they were #1 trying to hide the pregnancy, as well as trying to “stop” the pregnancy before it was discovered, not counting the teens who thought it was going to go away by itself of course- research in NEJM also indicates that both young and older teen mothers have increase in premature birth as well as small for dates)
and on the “elderly” gravida end
BUt the number one thing, would be to increase maternal health before conception.
Improve nutrition, both for the mother as well as the father ( helps prevent neural tube defects)
Attain goal weight, whether that be to gain or lose weight.
Participate in a healthy exercise program, a healthy circulation provides both mother and baby with essential nutrients.
As well as identify women at risk for giving birth prematurely, and teach them and their doctors danger signs.</p>
<p>You wouldnt’ believe the number of women that told me that their doctor told them “they couldn’t be in labor it was too early”</p>
<p>Could improved pregnancy detection technology have, in part, increased the reported number of pre-term births? The earlier you know that you are pregnant, the sooner you start counting when you are “due,” or, when babies are early, you have a much better idea of how early they are.</p>
<p>Not all teenagers have healthy births. Teenagers with drug issues and poor prenatal care are at high risk for pre-term births. </p>
<p>Emerald: I think you could change “miscarried” to “stillborn” and get the same picture from JHS’s post.</p>
<p>aa: I believe that teenagers with drug issues and poor prenatal care may be at risk for pre-term births, but that negative outcomes from those pre-term births in terms of infant mortality and morbidity are significantly less than with older mothers. This isn’t the kind of statistic that gets highlighted in press releases, for pretty obvious reasons. No one thinks it’s a good idea for teens to get pregnant, use drugs, not get any prenatal care, and have a baby, and certainly if the drug use is bad enough it will affect the baby. Prenatal care for teens often also addresses issues that don’t necessarily get defined as infant health issues. But – at least this is what I was told as of about 12 years ago – there is little actual public health effect (measured in terms of infant mortality and morbidity) from increasing teenage prenatal care, and a negative effect from reducing teenage pregnancy.</p>
<p>EK, like you, this news stuns, and saddens me. As someone who ‘did everything right’ and still experienced this three times, with a devastating result each time, it’s something which I had hoped would have diminished over the years. Sadly, it doesn’t seem to be the case.</p>
<p>I was also a premature baby and me and my parents had a similar experience to you. My parents became close friends of the other parents who were in the prem baby ward at the same time. All bound together under the stress of a situation that no-one else could understand quite like other parents having the same experience. When I was little I continued to go to health checks 3 times a year where my height and weight were measured along with other milestones of development. There were lots of other prem children there who had the same tests, many of them known to my parents. These visits stopped when I was 5 but I vividly remember being the only child in the room who could talk and trying to have a conversation with these other children (who I now realise were for the most part severely disabled. But I didn’t understand this at the time) which frustrated me because they couldn’t join in or play with me. </p>
<p>My parents were told that the chance of survival for such small babies in the early 80s was 1 in 5. But I’m in the lucky 20% and I am 100% physically and mentally healthy and never had any problems since. I am only 5ft4, but my mother is 4ft10 so shortness is probably genetic! One of the reasons I survived is that the hospital I was born in had just been given brand new incubators by a children’s charity. Perhaps if I had been born a few days earlier, before these machines arrived, I wouldn’t have made it? Anyway, I send that charity a donation every month because you don’t get that lucky twice in your life and now someone else needs the same help I received. I’ve appeared in the charity’s magazine too because I’m the first one of “their” babies to go to a mainstream school, to go to university, to graduate (and hopefully to get a PhD in January) etc etc.</p>
<p>There is also an increase in multiple births. That really jacks up the premie
rate. Also these days you hear more about premie births, since more of these precious babies have a shot at survival. Some time back, you would hear about someone losing her baby–technically a premie birth since the pregnancy was beyond the defined time for a miscarriage, but it would all be over pretty quickly it would seem. Our neighbors who have a set of two year old premie twins, had an ongoing drama for the three months that these adorable babies were hospitalized. Born after six months, they would not have had a chance twenty-thirty years ago.</p>
<p>“. . . I send that charity a donation every month because you don’t get that lucky twice in your life and now someone else needs the same help I received.” (cupcake)</p>
<p>What a wonderful attitude. Thanks for lifting my day.</p>
<p>My GD was was a 25 weeker who spent 4 months in NICU. We are blessed and grateful beyond words for wonderful medical care and her fighting spirit. She is fine in every way. </p>
<p>At the same time, it does make it more complicated to consider the issue of “viability” and the traditional perceptions of when that can happen. Certain European nations have a cut-off time in a pregnancy before which they will not try to sustain the new-born life. Knowing that, during the early days with an uncertain future, made it much harder for her parents, a week or so earlier and she would have had no chance.</p>
<p>I disagree with the OP post. My mother was 39 when she gave birth to me with no health problems. And I was her first child at 8lbs 14 oz. My cousin, who gave birth to my cousin at age 30, had scores of health problems. Fluid entered her lungs, and doctors had to do a C-section and the child was 1lb 13 oz. If they had not done this, my cousin would have died.</p>
