Archive for the ‘Prematurity’ Category

Thinking about pregnancy after premature birth

Wednesday, November 8th, 2017

Even if you do everything right, you can still have a premature birth. We don’t always know what causes premature birth, but we do know that if you’ve had a premature baby in the past, you’re at increased risk of having a premature birth in another pregnancy. If you have given birth early, here are some ways you may be able to reduce the chances of premature birth in another pregnancy:

Wait 18 months between giving birth and getting pregnant again

Waiting at least 18 months between pregnancies gives your body time to recover from one pregnancy so that is it ready for the next one. Use birth control so you don’t get pregnant again too soon. Talk to your provider about the best birth control option for you.

Schedule a preconception checkup

Being as healthy as possible when you get pregnant can help you have a healthy, full-term pregnancy. At your preconception checkup you and your provider can talk about:

Talk to your provider about progesterone shots

Progesterone is a hormone that helps your uterus grow and keeps it from having contractions. Progesterone shots may help prevent you from giving birth early again if:

  • You’re pregnant with just one baby.
  • You were pregnant before with just one baby and had spontaneous premature birth.

Get treatment for short cervix

Your cervix is the opening to the uterus that sits at the top of the vagina. The cervix opens, shortens and gets thinner and softer so your baby can pass through the birth canal during labor and birth. Having a short cervix increases your risk for giving birth early. Talk to your provider about cerclage and vaginal progesterone.

Take low dose aspirin to help prevent preeclampsia

Preeclampsia is a kind of high blood pressure some women get after the 20th week of pregnancy or after giving birth. If not treated, it can cause serious problems during pregnancy, including premature birth. If you have risk factors for preeclampsia, like you’ve had it before or you have high blood pressure or other health conditions, your provider may want you to take low-dose aspirin during pregnancy.

Quit smoking, drinking alcohol, using street drugs and misusing prescription drugs.

All of these can put your health and your baby’s health at risk and make you more likely to give birth early. Quitting or getting help to quit is the best thing you can do. Talk to your provider about programs that can help.

Learn the signs of preterm labor

Learning the signs and symptoms of preterm labor doesn’t reduce your risk of premature birth. But if you know them and know what to do if you have them, you can get treatment quickly that may help stop your labor. If you have any signs or symptoms of preterm labor, call your provider right away or go to the hospital.

Premature birth rate in U.S. increases for second year

Friday, November 3rd, 2017

For the second year in a row, the rate of preterm birth in the United States has increased. The premature birth rate went up from 9.6 percent of births in 2015 to 9.8 percent in 2016, giving the U.S. a “C” on the March of Dimes 2017 Premature Birth Report Card. The report card also shows that across the U.S., black women are 49 percent more likely to deliver preterm compared to white women. American Indian/Alaska Native women are 18 percent more likely to deliver preterm compared to white women.

More than 380,000 babies are born prematurely in the U.S. each year. An additional 8,000 babies were born prematurely in 2016 due to the increase in the preterm birth rate. Premature babies may have more health problems or need to stay in the hospital longer than babies born on time. Some of these babies also face long-term health effects, like problems that affect the brain, lungs, hearing or vision.

The Premature Birth Report Card provides rates and grades for all 50 states, plus the District of Columbia and Puerto Rico. Preterm birth rates worsened in 43 states, the District of Columbia and Puerto Rico. The rates stayed the same in three states (AL, AZ, WA), and improved in only four states (NE, NH, PA, WY).

  • Four states earned an “A” on the 2017 Premature Birth Report Card;
  • 13 states received a “B”;
  • 18 states got a “C”;
  • 11 states and the District of Columbia got a “D”;
  • 4 states and Puerto Rico received an “F.”

Among the 100 cities in the U.S. with the greatest number of births (latest data is for 2015), Irvine, California had the lowest rate of preterm birth (5.8 percent), and Cleveland, Ohio had the highest preterm birth rate (14.9 percent).

This year’s Report Card also includes a preterm birth disparity ratio. This measures the disparities in preterm birth rates across racial/ethnic groups in a geographic area. The disparity ratio shows that the differences in preterm birth rates among racial/ethnic groups are getting worse nationally and no state has shown improvement since the measurements started being recorded in 2010-2012.

There is no single cause of premature birth and therefore there is no simple solution. However, things like expanding research, increasing education, strengthening advocacy, and improving clinical care and community programs can all help. The March of Dimes continues to work towards giving every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

If you want to learn how you can help increase awareness of the serious problem of premature birth throughout November, check out our blog post.

Prematurity Awareness Month has arrived and here’s how you can help

Wednesday, November 1st, 2017

Here at the March of Dimes November means Prematurity Awareness Month. Although we work all year round to fight preterm birth, this month we are working especially hard to get the word out about the serious problems of preterm birth and how you can help us end prematurity.

Each year in the U.S., 1 in 10 babies is born prematurely. And being born too soon is not only the leading cause of death for children under the age of five, but it can also lead to long-term disabilities. This is a heartbreaking reality for too many families. That is why we are hard at work funding groundbreaking research, education, advocacy and community programs to help give every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

Here’s how you can help:

  • Join our Twitter chat with Show Your Love on November 16th at 12pm ET. Just use #PreemieChat
  • November 17th is World Prematurity Day. Share/Retweet/Repost March of Dimes social messages with your friends and followers on Facebook, Twitter, and Instagram.
  • Change your profile picture on Facebook with our branded World Prematurity Day frame.
  • Add a #worldprematurityday profile picture to your Twitter account with the WPD Twibbon.
  • Add your voice and sign-up to automatically post a message of support and awareness of prematurity on your personal Facebook and Twitter accounts on World Prematurity Day.
  • Participate virtually in our Imagine a World event! Make a short video sharing what you imagine for future generations. Post your video on social media using #MODImagines. Together, we’re imagining a world where every baby has the chance to thrive!

Create a purple movement!

  • Wear your March of Dimes gear and share photos using #prematurityawarenessmonth and/or #worldprematurityday and @marchofdimes.
  • Light your front porch/home/office lobby/building. Purchase purple lights through Amazon Smile! For every light purchased Amazon will donate 0.5 percent of the price of your purchase to the March of Dimes. Go to smile.amazon.com, select March of Dimes and use the search term “purple lights.”
  • Host an information booth in a prominent spot, such as outside your cafeteria, to promote November as Prematurity Awareness Month to your employees or coworkers.
  • Spread your gratitude by celebrating, thanking and remembering anyone who has helped you and/or the people you care about who have been affected by our mission.

We have much more in store this month, so stay tuned as we work to spread the word about World Prematurity Month.

What is a respiratory therapist?

Monday, October 30th, 2017

If your baby is in the NICU, you know that there are a lot of people caring for her and helping her to get stronger each day. One of those NICU team members may be a respiratory therapist. A respiratory therapist (or RT) cares for babies with breathing problems.

When your baby first arrives in the NICU, a respiratory therapist evaluates her breathing. The RT looks to see if your baby is breathing too fast, if the breaths are shallow, or if she’s struggling to breathe. Then, together with the rest of the NICU team, the RT develops a treatment plan to help care for your baby.

Here are some common conditions that a respiratory therapist may see in the NICU:

Breathing problems: Premature babies often have breathing problems because their lungs are not fully developed. Full-term babies also can develop breathing problems due to complications of labor and delivery, birth defects and infections.

Apnea: Premature babies sometimes do not breathe regularly. A baby may take a long breath, then a short one, then pause for 5 to 10 seconds before starting to breathe normally. This is called periodic breathing. Apnea is when a baby stops breathing for more than 15 seconds. Apnea may be accompanied by a slow heart rate called bradycardia. Babies in the NICU are constantly monitored for apnea and bradycardia (often called “A’s and B’s”).

Respiratory distress syndrome (RDS): Babies born before 34 weeks of pregnancy often develop RDS. Babies with RDS do not have enough surfactant, which keeps the small air sacs in the lungs from collapsing.

Pneumonia: This lung infection is common in premature and other sick newborns. A baby’s doctors may suspect pneumonia if the baby has difficulty breathing, if her rate of breathing changes, or if the baby has an increased number of apnea episodes.

Many babies who need treatment for breathing problems benefit from respiratory therapy. In fact, neonatal respiratory therapy has become its own medical sub-specialty. A neonatal-pediatric RT is trained to use complex medical equipment to care for the smallest babies with mild to severe breathing challenges. They visit their patients daily or as often as needed and are an important part of your baby’s NICU team.

Have questions? Text or email AskUs@marchofdimes.org.

March of Dimes-funded researchers have identified genes involved in preterm birth

Friday, September 8th, 2017

Premature birth is a complex problem with no single solution. Each year, about 15 million babies worldwide are born prematurely, and more than one million of them will die. Over 50 percent of the time, the cause of premature birth is not known. However, scientists have always believed that genetic factors play a role. A new study led by the March of Dimes Prematurity Research Center-Ohio Collaborative, is the first to provide strong information as to what some of those genetic factors are. The team identified six genes that influence the length of pregnancy and the timing of birth. The findings were published Sept. 6 in the New England Journal of Medicine.

This international team of researchers looked at the DNA of 50,000 pregnant women from around the world. The identification of these six gene regions allowed scientists to learn that:

  • The cells within the lining of the uterus play a larger-than-suspected role in the length of pregnancy.
  • Low levels of selenium—a common dietary mineral found in some nuts, certain green vegetables, liver and other meats—might affect the risk of preterm birth. Future studies will look at selenium levels in pregnant women who live in areas with low selenium in their diet or soil.

The six genes that have been identified can now be studied in more detail. The population of women in this study was mostly from Europe. Researchers are already trying to determine if these gene associations are the same for women from Africa and Asia.

Louis Muglia, MD, PhD, co-director of the Perinatal Institute at Cincinnati Children’s and principal investigator of the March of Dimes Prematurity Research Center–Ohio Collaborative stated, “This is just the beginning of the journey, but we think it leads to an exciting horizon where we can really make a difference in human pregnancy.”

The March of Dimes believes that these new findings will lead to new diagnostic tests, medications, improved dietary supplements or other changes that could help more women have full-term pregnancies and give more babies a healthy start in life.

Retinopathy of prematurity

Friday, August 25th, 2017

If you have a premature baby, you may have heard of retinopathy of prematurity or ROP. ROP is an abnormal growth of blood vessels in the eye.

During the last 12 weeks of pregnancy, the eye develops quickly. When a baby is born full-term, the growth of the blood vessels that supply the retina is almost complete. The retina then typically finishes growing the first few weeks after birth.

However, if a baby is born too early, the blood vessels may stop growing or not grow correctly. These vessels can then leak and cause bleeding in the eye. Scar tissue forms, and if the scars shrink, they may pull the retina loose from the back of the eye. This is called retinal detachment. Retinal detachment is the main cause of vision problems and blindness in ROP.

Risk factors for ROP

Some babies are more likely to develop ROP. Risk factors include:

  • Premature birth. Although all premature babies are at risk for ROP, it occurs most often in babies born before 30 weeks of pregnancy.
  • Apnea. This is when a baby’s breathing stops for 15 to 20 seconds or more.
  • Anemia. This is when the body doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body.
  • Heart disease
  • Infection
  • Trouble breathing or respiratory distress
  • Slow heart rate (also called bradycardia)
  • Problems with the blood, including having blood transfusions.

How is ROP diagnosed?

Your baby will get a special eye exam for ROP if she:

  • Was born before 30 weeks
  • Weighed less than 3 pounds at birth
  • Has any other risk factors for ROP

A pediatric ophthalmologist will examine your baby’s eyes. Babies born at 27 weeks or later usually have their first eye exam when they’re 4 weeks old. Babies born before 27 weeks usually have the exam later, because the more premature a baby is at birth, the longer it takes to develop serious ROP. Because ROP can develop later, it’s very important to take your baby to all of her eye exams, even after she is home from the NICU.

If your baby’s first eye exam shows that the blood vessels in both retinas have finished normal development, she doesn’t need a follow-up exam. If your baby’s eye exam shows that she has ROP and needs treatment, she should start treatment within 72 hours. Early treatment gives your baby the best chance of having healthy vision.

Treatment

Most mild cases of ROP heal without treatment and with little or no vision loss. In more severe cases, the ophthalmologist may perform laser therapy or do a procedure called cryotherapy (freezing) to eliminate abnormal blood vessels and scars. Both treatments help protect the retina.

If your baby has ROP, visit our online community at Share Your Story to connect with other parents for support and comfort throughout your baby’s treatment.

Have questions? Email us at AskUs@marchofdimes.org.

Getting ready for discharge from the NICU

Monday, July 31st, 2017

In general, your premature baby will be ready to go home around her due date. But your baby will have to reach certain milestones first. Her vital signsPreemie going home–temperature, breathing, heart rate, and blood pressure–must be consistently normal. This means that your baby:

  • Keeps herself warm
  • Sleeps in a crib, not an incubator
  • Weighs about 4 pounds or more
  • Has learned to breast- or bottle-feed
  • Breathes on her own

What can you do to get ready?

Make sure you talk to your baby’s health care provider and the NICU staff about caring for your baby at home. Here are some things to think about:

  • Do you have everything you need at home to take care of your baby? Do you have medicine and equipment your baby needs? Do you know how to give your baby medicine and use the equipment?
  • Are there any videos, classes, booklets or apps that may help you learn how to take care of your baby at home? Ask about taking a CPR class prior to bringing your baby home—knowing what to do in an emergency may make you feel more comfortable.
  • What do you want discharge day to be like? Do you want family or friends to be there when you and your baby get home? Or do you want it to be just you and your partner with your baby?

Many hospitals let parents “room in” with their baby for a night or two before going home. This can be a good way to practice taking care of your baby on your own while the NICU staff is still right there to help.

Car seat

You will be required to have a car seat before you leave the hospital. Preterm and low-birthweight infants have a higher chance of slowed breathing or heart rate while in a car seat. So your baby may need a “car seat test” before being discharged. The NICU staff will monitor your baby’s heart rate and breathing while she is in her car seat for 90 to 120 minutes. They may watch your baby even longer if your travel home is more than 2 hours.

Follow-up care

Make sure you have chosen a health care provider for your baby. You can choose a:

  • Pediatrician. This is a doctor who has special training to take care of babies and children.
  • Family practice doctor. This is a doctor who provides care for every member of a family.
  • Nurse practitioner. This is a registered nurse with advanced medical education and training.

If your baby has special medical needs, you may also need a provider who specializes in that condition. The NICU staff, hospital social worker or your baby’s general care provider can help you find someone.

Have questions? Send them AskUs@marchofdimes.org.

Medication before and during pregnancy

Monday, July 24th, 2017

Did you know that 7 out of 10 pregnant women take at least one prescription medication? According to the Centers for Disease Control and Prevention (CDC), the use of prescription medicine during the first trimester of pregnancy has increased more than 60% over the last 30 years. In the video below, Dr. Siobhan Dolan explains how taking some prescription medicines before or during pregnancy can hurt your baby. Learn how to make sure any medicines you take are safe for both you and your baby.

 

 

 

Have questions? Send them to our Health Education Specialists at AskUs@marchofdimes.org.

More babies being born too soon

Friday, June 30th, 2017

pregnant woman blood pressureFor the second year in a row, the preterm birth rate in the United States has gone up. Preterm birth is when a baby is born before 37 weeks of pregnancy. According to a preliminary report from the National Center for Health Statistics (NCHS), the preterm birth rate rose to 9.84% in 2016, up 2% from 9.63% in 2015.

 After seven years of a steady decline in the preterm birth rate, this increase is alarming.

Reduce your risk

We don’t know why this is happening. But we do know that there are some things a woman can do to help reduce her chance of giving birth too soon. Here are some of them:

  • See your prenatal care provider as soon as you think you’re pregnant. And go to all of your prenatal care appointments. Go even if you’re feeling fine. Prenatal care helps your provider make sure you and your baby are healthy.
  • Don’t smoke, drink alcohol, use street drugs or abuse prescription drugs. Ask your provider about programs in your area that can help you quit.
  • Talk to your provider about your weight. Ask how much weight you should gain during pregnancy. Try to get to a healthy weight before your next pregnancy.
  • Get treated for chronic health conditions, like high blood pressure, diabetes and thyroid problems.
  • Protect yourself from infections. Wash your hands with soap and water after using the bathroom, caring for small children, or blowing your nose. Don’t eat raw meat or fish. Have safe sex. Don’t touch cat poop.
  • Reduce your stress. Exercise and eat healthy foods. Ask for help from family and friends. Get help if your partner abuses you. Talk to your boss about how to lower your stress at work.
  • Wait at least 18 months between giving birth and getting pregnant again. See your provider for a preconception checkup before your next pregnancy.

 

Know the signs

If you have any of these signs or symptoms before 37 weeks of pregnancy, you may be having preterm labor. Call your health care provider right away if you have even one of these signs or symptoms:

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual
  • Pressure in your pelvis or lower belly, like your baby is pushing down
  • Constant low, dull backache
  • Belly cramps with or without diarrhea
  • Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.
  • Your water breaks

If you think you’re having preterm labor, call your provider. Call even if you have just one sign or symptom. There are several treatments that may help slow or stop preterm labor. And there are treatments, like antenatal corticosteroids (also called ACS), that can help reduce your baby’s chances for having health problems (like lung problems) in case he’s born early.

Have questions? Send them to AskUs@marchofdimes.org.

Preeclampsia: Impact on mom and baby

Wednesday, June 21st, 2017

May was Preeclampsia Awareness Month. We blogged about the signs, symptoms and causes of preeclampsia and how it may lead to premature birth. We also hosted a Twitter chat with Dr. Kjersti Aagaard of Texas Children’s Pavilion for Women, which generated some follow-up questions.

We’re happy to welcome back Dr. Aagaard and her colleague Dr. Martha Rac as guest bloggers. Both doctors are maternal-fetal medicine specialists at Texas Children’s. They will share some insight into who is most at risk of developing preeclampsia and how it can impact both mom and baby.

First, we must ask, who is at the highest risk for developing preeclampsia?

 Risk factors for preeclampsia include:

  • First time mothers
  • Pregnancy with a new partner than previous pregnancies – different partners may have varying genetic factors that may increase preeclampsia risk
  • Older mothers (>35 years old)
  • Black women
  • Medical problems including chronic high blood pressure, kidney disease, lupus, diabetes and heart disease
  • Pregnancies with multiples (twins, triplets, etc.)
  • Obesity
  • Preeclampsia in prior pregnancies
  • IVF pregnancies – particularly those with donor eggs. This is thought to occur as a result of genetic differences between the mother and fetus, causing the mother’s immune system to attack the “foreign” fetal tissue and cause excess inflammation.

In addition to the risk factors above, mothers with pregnancies spaced too closely together or very far apart can be at risk. Too close may be defined as 18 months or less and far apart as 4-5 years between pregnancies.

How does preeclampsia affect pregnancy?

Preeclampsia is classified as either mild or severe based on a woman’s symptoms, and how severely it affects her organs. It is a progressive disorder, which means that mild cases will eventually develop into severe preeclampsia, if not treated.

Preeclampsia can be very dangerous to both the mother and the baby. The very high blood pressure associated with preeclampsia can result in anything from seizures, stroke, liver and kidney dysfunction, bleeding problems, placental detachment and even death if left untreated.

If a mother-to-be suspects she may be experiencing preeclampsia, she should contact her doctor immediately.

How does preeclampsia impact the baby?

 This dangerous disorder can cause the baby’s growth to be restricted and increases the risk of stillbirth. In the most severe cases, preterm delivery may be required which may then expose the baby to the complications of prematurity such as under-developed organs, breathing difficulties, jaundice, anemia, a lowered immune system, etc.

In the worst cases, fetal death can occur from a sudden detachment of the placenta from the uterus.

For these reasons, women diagnosed with preeclampsia undergo additional monitoring such as: ultrasounds every 4 weeks to evaluate fetal growth, lab work to determine if there is multi-organ involvement, etc. and delivery no later than 37 weeks.

If you are worried you are at risk of developing this dangerous disorder, please be sure to consult with your doctor and discuss your concerns immediately.

Dr. Kjersti AagaardDr. Martha Rac

 

 

 

 

 

 

Many thanks to Dr. Aagaard  (left) and Dr. Rac  (right) for contributing their expertise.