WASHINGTON – Specialists called Thursday for more early ultrasound exams during pregnancy and tighter guidelines for infertility treatment as key first steps in battling a growing problem: One in eight babies now is born prematurely.
That’s more than 500,000 babies a year, a steadily rising number as the rate of premature birth has grown by more than 30 percent in two decades.
Helping these fragile infants survive and thrive costs the nation at least $26 billion a year, and there’s little likelihood of improvement soon, says a sobering report from the Institute of Medicine.
That’s because doctors don’t know the cause of most preterm births or how to prevent them, and have few good ways even to predict which women will go into preterm labor, concludes the report, which calls for urgent research to try to turn the tide.
Who’s at high risk?
* A previous preterm baby doubles the risk of a second.
* Carrying twins increases prematurity risk by 40 percent, odds that worsen with triplets or more.
* Some 17.8 percent of black women’s babies are born prematurely, compared with 11.5 percent for white women and 11.9 percent for Hispanics. That troubling difference can’t be fully explained by income, education or access to prenatal care.
* Women pregnant through certain infertility treatments have increased risk, mostly because they’re more likely to carry twins or more. But recent research suggests even single babies conceived by in-vitro fertilization are more likely to be preterm.
* Poor women are more at risk, as are those who are under age 16 or over 35.
* Certain infections can trigger preterm labor, and other risk factors include poor diet, maternal stress, lack of prenatal care and smoking.
The Institute of Medicine, independent advisers to the government, urged major new federal research into prematurity’s causes and how to prevent it. Until then, it recommended that:
* More pregnant women receive a first-trimester ultrasound exam, the only way to be certain of the fetus’ exact age. That’s particularly important if the woman later has labor induced or a Caesarean section before her due date, either elective or because of a possible health problem.
* Specialists should strengthen guidelines that reduce the number of multiple births as a result of infertility treatment. During in-vitro fertilization, doctors often implant several embryos at once into a woman’s womb.
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