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Dear friends,
November is Prematurity Awareness month, and the March of Dimes reports some good news in the slight decline in premature birth rates. But with 1 in 8 babies born premature in the U.S., we still have a long way to go.
If you haven't already done so, please take a moment to view our new organizational, video describing the work we do at LA Best Babies Network, and tell us what you think.
Your friends at LA Best Babies Network
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| California Gets a C on 2010 Premature Birth Report Card | 
On November 17, The March of Dimes released its annual Premature Birth Report Card for the United States. The good news is that, after increasing for three decades, rates of premature birth declined for the second year in a row. But, overall, the U.S. still received a grade of D, because it has failed to meet the Healthy People 2010 goal of 7.6%.
The 2008 national prematurity rate (births at less than 37 weeks gestation) improved to 12.3%, from 12.7% (in 2007). The March of Dimes says 79% of the decline was among babies born just a few weeks early.
One in eight babies born in the U.S. is premature, and premature birth remains the leading cause of death in the first year of life. The U.S. rate is higher than that of most other developed nations.
California's rate was 10.5% in 2008, an improvement over the 2007 rate of 10.9%. However, this was not enough to raise its C grade, and California's percentage of uninsured women of child-bearingage rose from 22.7% to 23.9% in 2008. (Current rates are estimated to be closer to 30%).
Said Dr. Jennifer L. Howse, president of the March of Dimes, "The two-year decline...though small, is encouraging. We believe this is the beginning of a trend, but it must be supported by better health care, new research, and adoption of intervention programs to lower the risk of preterm birth."
Known strategies that can lower the risk of an early birth include smoking cessation, preconception care, early prenatal care, screening and treating common urine and reproductive tract infections, eating a healthy diet and maintaining healthy weight during pregnancy, reducing stress, avoiding multiples from fertility treatments, and avoiding unnecessary C-sections and inductions before 39 weeks of pregnancy.
Learn more:
March of Dimes 2010 Premature Birth Report Card
March of Dimes 2010 Premature Birth Report Card Map
March of Dimes 2010 California Report Card
March of Dimes brochure Why the Last Weeks of Pregnancy Count explains why it's important not to schedule an induction or C-section for non-medical reasons before 39 weeks of pregnancy.
March of Dimes tool kit, Elimination of Non-medically Indicated (Elective) Deliveries before 39 Weeks Gestational Age for clinicians and patients to better understand the consequences of early elective delivery and the importance of the last weeks of pregnancy.
March of Dimes' Preterm Labor Assessment kit provides guidance for standardized assessment and diagnosis of preterm labor by health care professionals. |
| Pertussis Cases Highest Ever for LA County | |
Reported cases of whooping cough spiked in October, with more than a quarter of this year's cases occurring last month, according to the Department of Public Health. "This is an epidemic that is reaching numbers we've never seen before in Los Angeles County," said Jonathan E. Fielding, MD, MPH, Director of Public Health and Health Officer. "We received 101 pertussis reports for the first week of November alone, and 429 for the month of October." Four infants in LA County have died as a result of the disease.
"The best protection against pertussis is vaccination," said Dr. Fielding. "Whooping cough is a disease that is especially dangerous for infants under 6 months of age, who are not old enough to have received the number of vaccine doses needed to be fully protected. Vaccinations do not give you instant immunity, and take time to develop full protection. By taking action now, you can ensure that you are protected for the holiday gatherings."
Healthcare professionals recommend a "cocooning" strategy to best protect infants less than 6 months old. This means that anyone who has frequent contact with an infant should receive the Tdap booster vaccine, greatly reducing the child's risk of catching the disease.
"Infants are most likely to be infected by parents, grandparents, older siblings, day care workers, and other caregivers who have whooping cough but often don't know that this disease is the reason for their symptoms," said Dr. Fielding. "People suffering from a cough illness who have contact with infants should seek medical care immediately. Anyone who lives with or has frequent contact with an infant should ensure that their vaccinations are up-to-date."
Those who do not have a regular healthcare provider or insurance coverage for vaccines may dial 2-1-1 or visit www.publichealth.lacounty.gov/ip for referrals to providers and community sites offering immunizations free or at a reduced charge.
The California Department of Public Health recently expanded its vaccination recommendations in response to the epidemic. In addition to the usual series of childhood pertussis vaccinations, CDPH now recommends an adolescent-adult pertussis booster vaccine (Tdap) for:
- anyone 7 through 9 years of age who did not complete the pertussis vaccination series at an earlier age;
- all others 11 years of age and older, especially women of childbearing age, before, during, or immediately after pregnancy and seniors 65 years of age and older.
Learn More:
LA County Department of Public Health Pertussis Information
LA County Department of Public Health Provider Pertussis Information sheet
California Department of Public Health Pertussis Information
CDPH Pertussis Flyer for Pregnant Women (Spanish)
CDPH Pertussis Flyer for Pregnant Women (English)
LA Times Questions & Answers about Pertussis
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| Premature infants and Pertussis vaccine | Studies show DTaP is safe and effective for preemies.
the American Academy of Pediatrics recommends immunization of preterm infants at two months, with diphtheria-tetanus-acellular pertussis vaccine (DTaP), regardless of birth weight and gestational age, but many primary care providers do not follow this guideline.
The current pertussis epidemic in California and Los Angeles County puts infants at particular risk, and premature infants are even more vulnerable. So far, this year, 10 infants have died of whooping cough in California, 4 of them in LA County. One was an infant born prematurely at 28 weeks, who had received the first dose of vaccine at two months of age, but died 15 days later, before he was fully protected.
Although the full protection of vaccination is not achieved until at least 6-months of age, and a full series of shots, younger babies, including premature infants can begin to mount an immune response as a result of vaccination. Yet, many primary care providers do not follow the AAP guidelines due to fears of adverse reaction to the vaccine, such as cardiorespiratory events.
But a 2008 study published in the Journal of American Pediatrics concluded that preterm infants given the Dtap vaccine were no more likely to experience such adverse events than preterm infants who did not receive the vaccine.
Moreover, a recent study published in Clinical and Vaccine Immunology showed that premature infants are able to mount an immune response to pertussis, after receiving the vaccine at 2 months.
But it is just as vital for parents, infant caregivers, and any others who come into contact with babies to be vaccinated, as more than 50% of infants who contract pertussis catch it from a parent. Pertussis is highly contagious and the immunity provided by vaccination wears off after about 10 years.
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