Monthly Archives: January 2014

Born in the USA: Could Mean Higher Survival Rates for Premature Babies

According to the World Health Organization (WHO), although the rate of premature birth may be on an overall decline, this is not the case for most developing countries. The organization estimates that over 15 million babies are born prematurely (before 37 weeks gestation) annually, and this number is slowly increasing.

While the factors causing the increase in prematurity are varied, equally disparate are the survivability rates for premature infants around the globe.

A recent article published in The Guardian Online illustrates this point clearly. The article describes findings uncovered in a joint study between the US March of Dimes, the Partnership for Maternal newborn and Child Health, Save the Children and the World Health Organization which indicate that in “rich countries over 90% of babies born at [or after] 28 weeks survive, in poor countries only 10% do.”

In addition to the parents of premature babies in developing countries, no one more clearly witnesses the disparity in premature infant survival rates than healthcare researchers. Kyshia Robertson, a contract researcher for the National Institutes of Health (NIH) has worked on several infant mortality projects that study Latin American and African countries comparatively to the United States. Robertson believes that there is a widening gap in pre and post-natal healthcare options for prematurity between wealthy and developing countries.

“It is amazing to see what is available in the United States versus a place like West Africa where the levels of intervention for premature births are very limited. Unfortunately it does not look like this will change anytime soon. There are many factors; like public policy practices, political climate and economic stability that have a huge impact on how these babies will do when they come so early. We continue to see how the differences in these areas have a huge impact on whether a baby lives or dies.”

A part of Robertson’s research is centered on the impact of the early intervention practices employed immediately prior to and immediately following the birth of a premature baby. For example, in a country like the United States when a premature birth is inevitable, low-cost steroid shots are often given to the mother, which stimulate the production of lung surfactant in the fetus prior to birth. The administration of these steroids can substantially increase the survivability rate in preterm birth.

Survival Rates/Steroid Intervention Graph from NIH Data T. Leverett 2014

Survival Rates/Steroid Intervention Data from NIH data
T. Leverett 2014

Unfortunately, while these shots are readily available in the United States, they are not always available in developing countries, and Robertson believes that fixing this would be a good place to start.

“We can never expect to go from almost nothing to a high level intensive care nursery overnight, but we can work towards incremental improvements to care, like these shots, to hopefully give some of these kids a fighting chance,” she says.

Finding the Positives In Prematurity

According to the Centers for Disease Control (CDC), one in eight babies is born prematurely in the United States.

Immediately after these early arrivals are born, new parents are inundated with information about the potential illnesses, the likelihood of survival and the long course of treatment their newborns may face.

For some, the stress caused by focusing on these potentially negative outcomes while watching a child endure weeks of medical intervention is almost unbearable, and can lead to severe mental illness and the disruption of normal family life.

Tommy’s, a London based organization that funds research into issues surrounding pregnancy and childbirth, suggests that while most of the focus tends to be on the mother following a premature birth; fathers, siblings and even grandparents can also feel the same levels of overwhelming stress.

In an effort to combat the lasting impact premature birth can have on families, the National Institutes of Health (NIH) conducted a series of investigations to determine if intervention programs geared toward creating positive experiences for families of premature infants could change the outcomes for the better. In most of the investigations, intervention programs were found to not only improve the emotional state of families, but also resulted in improved long term outcomes for the babies.

The Hospital of the University of Pennsylvania is one of the many hospitals that provide intervention programs parallel to the NIH guidelines. At their bi-monthly “ICN Parent Coffee Hour”, parents of premature infants meet to talk about their experiences and to do something they don’t often get to do…focus on the positive.

Tracy D. (names changed to protect identity) the mother of 31 “weeker” twins (now two months old) often attends the Coffee Hour to share candid thoughts about her experience.

“I never knew how strong I was until I had my twins at 31 weeks. One of them came out unresponsive and had CPR immediately. I now know I am a strong woman. Having preemies makes you happy for the little things, and until you almost lose them you may not realize how lucky you are to have two screaming babies! It feels good to share that with other mothers who understand that.” Tracy says.

Sydney M., the mother of a 28 “weeker” and a past Coffee Hour participant also discusses her experience.

“I know for me, my faith grew stronger…it had to. My relationship with my husband grew stronger. We readily see the incredible gifts we have been given, and we know that it is only due to God that we have two perfect preemies, now two and a half and five months. We stop to smell the roses and take so much joy in the tiny little developments they make. Having my preemies gave me new heroes. I suppose all of those are indirectly positives for our children because we have become stronger because of them. We learned who our real friends are…the ones who understood why we weren’t social and were still there [at the hospital]. That said, if I never had to go through it again, I would be totally fine with that!”

While the parents of preemies appreciate the camaraderie found at the Penn ICN Coffee Hour and programs similar to it, the full impact of these programs may not be felt until long after the babies are home from the hospital.

According to Dr. Heather French, a Neonatologist at the University of Pennsylvania Hospital, outcomes for premature babies are not solely dependent upon medical intervention. She believes that programs like the Coffee Hour provide an important outlet for parents of premature babies, which often helps families adapt to their new lives.

She says, “Although we can look at a range of outcomes from a medical standpoint, when premature babies go home to a loving, stimulating environment they often succeed well beyond what the ‘statistics’ would dictate. It is important for families to be prepared for when their babies come home, and mental health and stability are an integral part of that process.”

5 Ways to Love a Preemie Infographic – T. Leverett

iPreemie: New Apps and Tech Advances work to Calm Parents of Preemies

Parenting a premature infant presents a unique set of challenges, which include selecting the right course of treatment from several confusing options, weighing potentially life-altering decisions with uncertain outcomes and struggling to create a strong bond with a hospitalized baby. Several studies suggest that parents display symptoms of PTSD after their premature babies are released from the hospital. Although there is no way to alleviate the parental stress involved with this experience, technology can help parents as they await the day they can bring their child home.

Dorothy Thompson, freelance writer, “preemie parent counselor” and mother of a premature infant (now thirty years old) reflects on her experience as a premature mother and how much things have changed.

“I had my son when I was six months pregnant, and at that time the outlook was not good at all. Medical intervention has come a long way, but I think the resources out there for parents has come just as far. There is so much information available that people don’t have to feel so alone”, Thompson said.

Premature infant shortly after birth
T. Leverett 2013

Much of the information available to parents of premature babies is found on websites and social media platforms, but the number of apps and other tech products geared toward preemie parents is growing.

Thomas suggests that parents take advantage of all the resources available to them especially when they are new to the neonatal intensive care experience.

“I tell parents to look at the apps, look online for information and always voice your questions and concerns to your child’s care team. They can use technology for two things, to become more informed about what is happening, but also to connect with people who have been where they are. That’s a very important step in this process.”

Some of the apps Thompson suggests to the parents she coaches are MyPreemie, NICU Words and NICU Knowledge Parent Educator. These apps provide information about terminology, medicines and treatments, feeding, growth and other aspects of the rigors of the NICU.

Some hospitals also offer the newly launched NICVIEW app, which allows parents to see their child on their smartphone. Although not available in all areas, Thompson believes this kind of technology can drastically reduce parent’s stress levels.

Premature infant in NICU
T. Leverett 2013

Thompson says, “This is the kind of thing that can help keep parents sane, and I wish there was something like this when I had my son. I think a huge part of the problem is the fact that parents can’t see their kids whenever they want to while they are in the hospital. With this app, they can feel much closer to their babies which at the end of the day helps both the baby and the parents”.