For every success story, there are tales of irreversible health problems such as cerebral palsy, developmental delays, impaired vision, and chronic lung disease, with one in four premature infants - defined as those born before 37 weeks - experiencing lifelong problems that result from early birth.
Doctors counsel women with vaginal bleeding, early contractions, or cervical abnormalities to stay in bed, take time off work, and minimize stress, despite real evidence that these measures work, according to Dr. Errol Norwitz, chair of obstetrics and gynecology at Tufts Medical Center.
Herculean efforts to prevent preterm births have resulted only in modest progress: the nation’s preterm birth rate has declined a bit over the past four years, slipping to under 12 percent of total births for the first time in nearly a decade after steadily rising to a peak of nearly 13 percent, according to a November report issued by the National Center for Health Statistics. But more than half a million premature births still occur every year at an annual cost to the US health care system of $26 billion. (The average medical costs incurred by a healthy full-term baby through the first year of life is slightly less than $5,000, compared with $50,000 for a premature infant.)
“We’ve gotten much better at determining who’s most at risk of preterm birth, but have made little headway at preventing it,’’ said Norwitz.
Some headway has been made at preventing known risks such as vaginal infections and smoking. And Massachusetts is doing somewhat better than other states, with a preterm birth rate just under 11 percent, likely because of its smoking cessation programs and universal health coverage, public health specialists speculate. But it also faces unique challenges.
