1. Preterm Birth: A Kentucky Health Concern This information has been prepared for you by:

2. How Long Is a Full Term Pregnancy? A full-term pregnancy lasts about 40 weeks You may have heard that a pregnancy should last 9 months 9 calendar months = 40 weeks

3. Due Date Also called: –EDC (Expected Date of Confinement) –EDD (Expected Date of Delivery) It is an estimate Even Ultrasound is not 100% accurate for predicting the due date

4. Preterm Birth “Preterm” is another word for premature – born before the time the baby would be “full term” or fully mature Like all living things, babies need time to grow and develop before their organs can function and handle being outside the womb A baby born at less than 37 weeks is born preterm and therefore is premature

5. Healthy Babies are Worth the Wait, because… Prematurity is the leading cause of newborn death Medical complications are common in premature babies

6. Medical Complications Common to Premature Babies: Premature babies can suffer lifelong consequences, such as: –Mental retardation –Blindness –Chronic lung disease –Cerebral palsy Premature babies are also more likely to have diseases such as heart disease and diabetes as adults

7. Late Preterm Infants Babies born between 34 and 37 weeks are called –“Late Preterm” infants –4 to 6 weeks early Often not low birthweight Often appear healthy and go to the normal newborn nursery, but may not be as healthy as they look

8. Healthy Babies are Worth the Wait, because… Even Late Preterm Infants are at higher risk for problems at birth, such as –Breathing problems –Temperature instability –Jaundice –Feeding problems –Low blood sugar Late preterm infants are also at higher risk for problems later in life: –Chronic Health problems –Hyperactivity or ADHD –Significant behavior and learning problems

9. Healthy Babies are Worth the Wait, because… Late preterm infants also have: –Higher risk of dying in the first year of life than full-term babies –Higher risk of being admitted back to the hospital with problems than full-term babies –Brains which are much smaller and underdeveloped compared to full-term infants

10. Development of the Human Brain Through Pregnancy The brain is the last major organ to develop The baby’s brain at 35 wks weighs only 2/3 what it will weigh at term Lots of important brain growth happens in those last few weeks

11. Who is likely to have a preterm baby? No one can predict who will have a preterm birth Preterm labor can happen to any pregnant woman

12. …However, Some Women are at High Risk for Preterm Labor and Preterm Birth: Women with a previous baby born preterm Women pregnant with twins, triplets or more Women with certain uterine or cervical abnormalities

13. Other Factors that Increase the Risk for Prematurity Medical Factors Infections Diabetes High Blood Pressure Clotting problems Bleeding from the vagina Short time between pregnancies Woman who is very overweight or very underweight Lifestyle factors Smoking in pregnancy Late or no prenatal care Drinking alcohol Using illegal drugs Excessive use of prescription drugs Domestic Violence Stress Lack of social support

14. The Costs of Prematurity are Many: The emotional toll Impact on business –Direct employer health care costs –Loss of productivity Hospital costs Costs to the community’s early intervention and education systems Costs of treating chronic illnesses

15. Hospital Costs Total NICU charges related to preterm birth in Kentucky were $204,504,246 for calendar year 2005 with average charges ranging from $11,000-$88,000 KY Hospital Discharge Database, 2005

16. Hospital Costs Total amount paid by KY Medicaid for prematurity related initial hospitalization stays for calendar year 2005 was $7.4 Million Medicaid paid out more than 4 times as much for the care of babies 35-36 weeks (late preterm infants) as they did for babies less than 26 weeks (micropremies). KY Medicaid Claims Database, 2005.

17. Average Hospital Stays 2.0 days for newborns without complications 13.6 days for infants with any diagnosis of prematurity or low birthweight 24.2 days for infants with a principal diagnosis of prematurity or low birthweight

18. A Silent Crisis Prematurity has been increasing steadily and alarmingly over the past two decades It now affects one out of every eight babies born in the United States

19. Percent of Live Births that were Preterm*; Kentucky and U.S., 1994-2004 *Preterm birth is defined as any live birth occurring <37 completed weeks gestation Data Source: March of Dimes Peristats

20. Prematurity in Kentucky The rate of preterm births is increasing twice as fast in KY as it is in the United States In Kentucky 1 out of every 7 babies are born premature In some regions of Kentucky, 1 out of every 5 babies is born premature (20%)

21. 14.4 15.6 12.9 12.6 13.8 13.9 15.5 9.0 14.2 13.9 15.3 18.3 13.9 17.6 13.1 Purchase Pennyrile Green River Barren River Lincoln Trail Lake Cumberland North Central Bluegrass Northern Kentucky Buffalo Trace FIVCO Gateway Big Sandy Kentucky River Cumberland Valley Percentage 9 - 11 11.1 - 13.1 13.2 - 14.4 14.5 - 15.6 15.7 - 18.3 14.4% of all babies born in Kentucky are premature – that is one in every 7 babies *2004 data is preliminary and numbers could change **Preterm birth is defined as any live birth occurring before 37 completed weeks gestation Note: Area Development District is based on the Mother’s county of residence at time of birth Data Source: Kentucky Vital Statistics Files, Live Birth Certificate Files, 2004 Percent of Live Births to Kentucky Residents that were Preterm** by Area Development District; Year 2004*

22. What Can We Do? Raise awareness of the effects associated with premature births, including late preterm births, on families and entire communities Raise awareness of risk factors for preterm labor and birth Raise awareness that some preterm births can be preventable

23. What Can We Do? Encourage all women to have healthy lifestyles before, during, and after pregnancy Help pregnant women you know to stop smoking (currently one in four pregnant women in KY smoke) Eliminate alcohol and drugs during pregnancy Encourage women to plan their pregnancies

24. What Can We Do? Educate women about: –Good health before and during pregnancy –Warning signs of preterm labor –What to do if warning signs occur –Why Healthy Babies are Worth the Wait

25. Encourage Pregnant Women to Use Community Resources HANDS Program for first time parents (mother or father) Kentucky Quit Line for pregnant smokers: 1-800-QUIT-NOW For more information about these & other programs, contact your local health department.

26. www.prematurityprevention.org KFAP is a statewide partnership dedicated to promoting perinatal health issues through community action, mass media and health professional education. Any interested person is invited to join. For more information: www.kfap.org

27. Additional Resources wwwmarchofdimes.com –March Of Dimes has many resources on their website for health professionals and the public wwwkentuckyperinatal.com –This organization has developed an online continuing education course on prematurity for physicians and nurses www.smokefreefamilies.org –This organization has information and materials for families and professionals to help pregnant smokers quit smoking. Smoking is one of the preventable causes of preterm birth, and in Kentucky one of 4 pregnant women smoke

28. A full term pregnancy is 40 weeks. Healthy Babies are Worth the Wait!!! Thank you for helping get the message out !

29. Thank You From: