From the May 2011 issue of HealthCare Business News magazine


When it comes to elective, non-medically indicated deliveries, March of Dimes recommends establishing quality improvement programs and facility-based protocols that would reduce or eliminate birth before 39 completed weeks of gestation.

The frequency of delivery before 39 but after 37 weeks may have created a “false sense of security,” says Gregory. Because physicians often tell women it’s OK to go into labor after 37 weeks, many have internalized it to be a safe number of weeks in the womb.


Thus, many physicians and patients have a hard time accepting that there is a true difference between a baby born at 37 and 39 weeks. “And that’s due to what you see every day,” explains Gregory. “If you delivered 100 babies at 37 weeks and they all came out perfect, it’s hard to believe it’s a problem. But in order to see the problem, you have to see maybe 1,000 or 2,000 babies. You need a bigger denominator to understand the implications of the problem,” she says.

Cedars-Sinai is in agreement with March of Dimes’ advice. At the facility, a birth prior to 39 weeks must be accompanied by a documented reason for the delivery. “A lot of hospitals are [carrying out] very active campaigns to educate both patients and doctors,” Gregory says.

Continuous research
Providers are also optimistic about evolving research around interventions that may reduce preterm births or provide better protection for vulnerable infants.

In early April, the National Institutes of Health shared the promising findings about progesterone, a naturally produced hormone. It was shown to reduce the rate of preterm birth before 33 weeks by 45 percent among women with short cervixes, a characteristic known to heighten the risk for premature delivery.

There is also ongoing research around the impact of magnesium sulfate on protecting a premature baby’s brain. “Learning how to use that judiciously may also help decrease the incidence of death after preterm birth,” says Gregory. “That’s something that’s evolving right now.”

Improvements in neonatal intensive care units and better access to health insurance and prenatal care among high-risk populations can all contribute to improved outcomes.

To ensure the research around infant death and preterm birth continues to uncover new trends and effective strategies, March of Dimes is pushing for the support of entities such as NIH and the National Institute of Child Health and Human Development on the policy front.

“What we’re really focusing on now is trying to advocate for key programs that we want to make sure continue to get the funding they deserve to address [preterm birth] issues,” says Berns.

May 2011 Magazine

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