U.S. preterm birth rate goes down but Kentucky's maternal smoking rate still second highest, putting preterm babies at risk

For the fifth year in a row, the preterm birth rate in the United States has dropped. Which is great news. But Kentucky again had a significantly high smoking rate for expectant mothers -- at 32.2 percent, putting us behind only West Virginia (at 36 percent) of pregnant women who gave birth preterm and smoked.

Being born before full term puts babies at undue risk. Still, nearly half a million babies in the United States are born prematurely, many unnecessarily, according to the March of Dimes' 2012 Premature Birth Report Card. Serena Gordon of HealthDay reports that "those risks include breathing difficulties, heart defects and bleeding in the brain. Some conditions are only temporary while others can persist." A premature birth is anything that occurs before 37 weeks gestation. Maternal smoking is a major factor respiratory difficulties for the child and in an inability for the mother to go full term.

It is also been found that women without health insurance also have a higher incidence of preterm birth. Texas had the worst rates of uninsured women with 34.2 percent without insurance. Florida and New Mexico had rates of uninsured women of about 30 percent. Kentucky had rates of uninsured women of 21.7 percent. (Read more)

To see the full report and to see how Kentucky fared compared to other states in a number of other categories, go here.

Study: Grandparent caregivers aren't up on latest safety standards for babies and children

Grandparents might be more quick to say yes to grandkids but they might also be a little behind the times on the the new safety guidelines that could better protect them. A new study finds that many grandparent caregivers don't know about those new health suggestions and, in some cases, laws for babies -- such as appropriate sleep position, crib safety and car seat use. This is particularly critical in a country where 2.8 million grandparents are primary caregivers to their grandchildren, an increase of nearly 20 percent since 2000, according to the the 2011 American Community Survey.

In this study, reporter Robert Preidt of HealthDay writes that 56 percent of grandparents asked got the question about the safest sleep position of babies wrong. (The correct answer is on their backs, according to the American Academy of Pediatrics.) "Another question addressed correct car seat positioning, and 24.5 percent of the participants said that a 9-month-old, 22-pound child should be facing forward. The AAP recommends, however, that children remain in rear-facing car seats until age 2 years." It doesn't get much better. Almost half of those grandparents questioned thought it was OK to have bumpers, stuffed animals and blankets in cribs. It's not.

We know it's difficult but maybe it time to have the talk. (Read more)

Use of pacifiers could lead to very sick babies, study finds

Oklahoma State University researchers report that they have found a wide range of disease-causing bacteria, fungus and mold on pacifiers that young children had been using.

In research presented at the American Society for Clinical Pathology, scientists have shown that pacifiers can also grow a slimy coating of bacterial film that alters the normal bacteria in a baby or toddler's mouth, increasing the likelihood of colic and ear infections. It gets worse, according to study author Tom Glass, a professor of forensic science, pathology and dental medicine: The same types of bacteria found on a common pacifier have been linked to cardiovascular disease, metabolic syndrome, allergies, asthma and autoimmune diseases.

HealthDay reporters Barbara Bronson Gray writes that Glass said the problems associated with pacificers are also applicable to any removable orthodontic appliance like retainers, mouth guards and dentures. Glass said his researchers were particular concerned about their findings when they discovered that "many of the bacteria growing from the used pacifiers were resistant to commonly used antibiotics such as penicillin and methicillin. The development of such resistance to certain antibiotics does not cause the organism to be more infectious than other strains that have no antibiotic resistance, but it can make the infection more difficult to treat." Glass told Gray that he does not recommend that pacifier use. use. "After doing the study, I say why take a risk?" (Read more)

Norton Healthcare implements a mobile application that allows doctors to monitor patients, especially expectant mothers

 

Norton Healthcare is the first health-care provider in Kentucky to implement a patient monitoring system that allows obstetricians to monitor expectant mothers while they're in labor via the physician's smart phone or tablet. The real-time application uses wave-form technology and works with iPhones, Androids, BlackBerrys and a variety of Windows Mobile devices. Its use has been cleared by the U.S. Food and Drug Administration.

The implications are vast for doctors in busy urban settings as well as for those in rural areas where doctor shortages may limit a physician's personal attention to individual patients. According to Norton Healthcare press materials and their obstetrician spokesperson, Dr. Reed Netter, the application allows the doctor to view "the same patient information that he or she would see at the patient’s bedside, looking at the monitor for heartbeat, contraction patterns, or signs of distress." This could save valuable time when a fetus is in trouble or if nurses see something that worries them.

The applications of the technology are evident for use in ambulances, in intensive care units, operating and emergency rooms, said Steve Heilman, Norton's system vice president and chief medical information officer for Norton Healthcare. (Read more)

Kentucky doctor honored for her work in bolstering health and preventing deaths of babies born a few weeks early

A Kentucky neonatalogist was honored this week for giving the state "a role in catalyzing a national movement around healthier babies." Ruth Ann Shepherd, M.D., division director for maternal and child health in the Kentucky Department for Public Health, was presented the Association of State and Territorial Health Officials Presidential Meritorious Service Award and recognized as "an early pioneer in recognizing the critical public health problem of preterm births in Kentucky, and that the troubling trend was common to most states in the country."

According to New Public Health, an online publication of the Robert Wood Johnson Foundation,  Shepherd’s research "revealed that babies born at 37 or 38 weeks had far worse health outcomes than babies born at 39 or 40 weeks. With support from the leadership at the Kentucky Department of Health, and many other organizations who have since taken up the cause of helping to create conditions for healthier babies, many states are beginning to make strides in preventing early births."

Charles Kendall, chief of staff at the Kentucky Health Department, told the online magazine that the  prematurity rate for infants in Kentucky was exceptionally high, averaging at about 36 weeks at the time of birth.  "There was a corresponding infant death rate that was far exceeding the national average When she looked at the data, it occurred to her that many of those deaths could have been prevented.," he said. "Much of the prematurity rate had nothing to do with medical issues. The data were telling her that women who smoke are much more likely to deliver early and to have smaller babies. The size of the baby was really the predictor for the infant death rate."

 But what Shepard also understood, said Kendall, was that a lot of these births were actually planned for convenience. "That was one of the more startling pieces of information from the data. In many cases it was not a medical issue but a lack of education or convenience. She also brought the science from her work that showed that the fetal brain is still in critical stages of development in those early weeks, and that it’s not at its full capacity until 39 or 40 weeks. That was very compelling. She also said this is not just a Kentucky issue. This is going on everywhere." ( Read more

Infant mortality, pre-term birth, teenage pregnancy, children living in smokers' homes all drop even as as child poverty goes up

Nationwide, the rates of infants who die, babies who are born prematurely, teens who are having babies, and the percentage of young children who live in a home where someone smokes have all decreased in the last five years. But the percentage of kids who live in poverty has gone up.

These findings are some highlights of the report "America's Children in Brief: Key National Indicators of Well-Being, 2012," compiled by the Federal Interagency Forum on Child and Family Statistics. The report, which does not break down data by state, looks at children's demographic backgrounds, family and social environments, economic circumstances, health care, physical environment and safety, behavior, education and health.

"This year's report contains good news about newborns," said Dr. Alan E. Guttmacher, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. "Fewer infants were born pre-term and fewer died in the first year of life."

Among other findings: In the last five years there has been a five-fold increase in the percentage of teens who have received the vaccine that prevents the most dangerous form of meningitis. Other key findings show:
• A drop in the percentage of children who live in homes that are classified as food insecure.
• A drop in the percentage of teens ages 16 to 19 who don't work and are not enrolled in high school or college.
• A rise in the percentage of children from birth to age 17 who live in counties in which one or more air pollutants were above allowable levels.
• An increase of one statistical point in the average math scores for 4th and 8th graders from 2009 to 2011. For a quick glance at the findings, click here. (Read more)

Mothers should try to go to full term in their pregnancies, but many are unaware of the risks of early delivery, UK study finds

Illustration by Michelle Kumata via KRT

Babies who are born before the full term of 40 weeks may have health problems later in life, since important brain development takes place in the very last stages of pregnancy. As such, mothers should try to avoid being induced early or having elective C-sections.

A study conducted at the University of Kentucky College of Communication and Information found women often don't realize the important development that takes place at the end of pregnancy, write UK doctoral student Sarah Vos and H. Dan O'Hair, dean of the college, for the Lexington Herald-Leader.

Evidence shows that early, elective births are expensive. One study found reducing the number of elective births before 39 weeks of gestation to less than 2 percent of all U.S. births would save $1 billion each year.

But many women are uncomfortable at the end of their pregnancy, are anxious to know their children are healthy, and may even ask for early induction of labor because employers aren't flexible about time off. Sometimes doctors and other providers induce women early for their convenience.

Encouraging women to go full term and telling them the disadvantages of early labor — problems feeding and a higher incidence of Sudden Infant Death Syndrome — can influence their decision. As Vos and O'Hair conclude, "Babies are worth the wait." (Read more)