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Dear friends,
November 17th is Prematurity Awareness day, and LA Best Babies Network is pleased to unveil its Perinatal Scorecard for LA County. It spotlights 11 perinatal indicators that reveal how LA County is doing in caring for mothers-to-be, babies, and families. We hope you wil read it and share it with your colleagues.
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Prematurity Awareness Month
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 Born Too Early
Premature birth (at less than 37 weeks gestation)
is the leading cause of death for newborns in the U.S. and a
public health crisis.
More
than 15,000 babies a year--or one in eight-- is premature, a higher rate than
in most other developed nations. In fact, the U.S. ranks 30th in the
world in infant mortality, largely due to its high prematurity rates, according
to a newly released report by the Centers for Disease Control and Prevention .
Preterm babies are almost always low birthweight
(weighing under 5 pounds, 8 ounces), which is associated with speech, vision
and hearing impairments, and even death. Preterm birth can result in lifelong health
complications, and the costs to society and the healthcare system are
substantial. Caring for a full-term baby during the first year of life costs
about $4,500, compared to nearly $50,000 for premature or low birthweight
infants.
On Prematurity Awareness day, LA Best Babies Network released its Perinatal Scorecard, which explores some
of these alarming trends in LA County, and highlights ways to reverse them. In
LA County, between 1997 and 2007, preterm births increased from 10.4% to 11.4%
of all live births. Fully 1.7% of births are very preterm, at less than 32 weeks gestation, and these babies are the most likely to
have serious complications, including death. Preterm births occur
nearly twice as often to African American mothers as to white mothers.
While the causes of preterm birth are often unknown, there
are some clear risk factors, such as maternal and fetal stress, uterine
bleeding, infections, and maternal smoking. Assisted Reproductive Technology
[link] often results in multiple gestations, and these babies are very likely
to be preterm and low birthweight.
Another
preventable cause of preterm birth is elective
deliveries in the absence of evidence-based medical indications, performed
before the 39-week mark. Inductions may contribute
to the growing number of babies who are born "late preterm," between 34 and 36
weeks gestation. While babies born at this time are usually considered healthy,
they are more likely to have medical problems than babies born a few weeks
later. Even infants born at 37-38 weeks have an increased risk of ending
up in neonatal ICU. A 2007 Hospital Corporation of America study carried out in
conjunction with the March of Dimes, at the request of ACOG, revealed that almost 1/3 of all babies
delivered in the United States are electively delivered, with 5% of all
deliveries in the U.S. in violation of ACOG/AAP guidelines.
All women should receive adequate preconception and prenatal care that addresses modifiable risk-factors for preterm birth, and pregnant women should
be informed of the risks of early delivery, cesarean sections, and multi-fetal
pregnancies. Such steps could go a long way toward improving LA County's, and
the U.S.'s,
rate of premature births and our woeful infant mortality rate.
How LA Best Babies Network is making a difference:
- The Healthy Births Care Quality Collaborative works with 10 LA County
clinics to provide evidence-based, high-quality, comprehensive prenatal care
including screening for common urinary and reproductive tract infections, healthy
nutrition and depression.
- The Network's Best Babies Collaboratives draws on the expertise of
40 local agencies in communities with a high proportion of high-risk
pregnancies, to provide coordinated prenatal and interconception
care, outreach, health education and social support.
- Home visitation programs, which begin during pregnancy and continue
for at least two years, help women at a high risk for preterm births (such
as first-time mothers or teenagers) access an array of educational and
health services.
Learn More:
Hospital Corp of America Study
National Institutes of Health study on preterm birth
Cost of Prematurity and Low Birthweight
The Joint Commission Recommendations on elective deliveries
Signs and Symptoms of Preterm Labor and What to Do
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Perinatal Scorecard
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LA Best Babies Network releases Perinatal Scorecard for LA County
On Prematurity Awareness Day, Lynn Yonekura, MD, LA Best
Babies Network's executive director, unveiled its Perinatal Scorecard, at at Town Hall Meeting hosted by the March of Dimes California Chapter. The Scorecard presents sobering data on mothers and their infants in LA County.
The perinatal period is the time around childbirth, from three months before
pregnancy until one year after birth-crucial to a child's lifelong health.
The Scorecard--the first
report to focus on the perinatal landscape of LA County, highlights 11 interrelated perinatal
health indicators, chosen because they
each represent problems that can often be avoided: -
preterm
birth
-
low
birthweight
- infant mortality
-
lack of
a medical home
-
unintended
pregnancy
-
multiple
births
-
maternal
mortality
-
teen
pregnancy
-
maternal
depression
-
lack of
breastfeeding
-
child
abuse and neglect
The Scorecard examines regional, ethnic, and economic disparities in LA
County, including:
-
More
than 13% of African American babies were born weighing less than 5 pounds, 8 ounces
in 2008.
-
Preterm
births occur nearly twice as often to African American families as white
families.
-
The
infant mortality rate in the Antelope Valley is more than double the infant death rate in West Los Angeles.
-
15- to17-year-old
Latinas are 7 times as likely as white teens to give birth.
-
West LA has
the county's highest multiple births rate.
-
White
and African American women were far more likely to have a medical home before
pregnancy than Asian American women or Latinas.
-
Latina and African American women reported being
depressed during pregnancy more than twice as often as white women.
-
In 2005, 34% of women surveyed reported
depressive symptoms during pregnancy. Only 3% were diagnosed with a mental
health problem.
The report offers a set of recommendations
to reverse some of these alarming trends, aimed at providers, policy-makers, and women and families: Cesarean births and medically induced preterm births should only be performed when there are
evidence-based obstetrical or medical indications. Extend Medicaid coverage to
low income women. Create more
baby-friendly hospitals. Teach every woman to have a reproductive life plan.
Expand home visitation services for new parents. Encourage employers to
create breastfeeding-friendly workplaces. Mandate mental health screening to
identify new mothers suffering from postpartum depression and refer them for
treatment.
Get a copy of the Perinatal Scorecard here
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Have a healthy and happy Thanksgiving!
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