It is obvious that the Nayday Suleman, aka Octo Mom, story has captured the nation’s attention.  Everyone has an opinion, and usually very strong ones.  Love her or hate her, we at Reality Rounds would like to take the opportunity to use her.  Yes, use her.  Before she fades from the national spotlight, and is relagated to become a contestant on Celebrity Apprentice (that would actually be kinda cool), we will use her to put a spotlight on prematurity.

Prematurity, defined as a baby born before 37 weeks gestation, is one of the leading causes of death and injury to infants in the world.  The U.S Department of Health and Human Services launched the Healthy People 2010 initiative in 1998 to tackle the most preventable health conditions that face this nation.  One of their objectives is to reduce the rate of premature births to 7.6%.  So how are we doing?

The rate of premature births has actually increased in this country, from 11.8% in 1998, to 12.7% today!

Why in the most technically, and medically advanced country on earth, is this happening.  This post will go over why the prematurity rates in the United States have increased, (and yes, cases like Nayda Suleman’s is a small part of the reason).

Reasons why premature births have increased in the America:

• Increase use of Assisted Reproductive Technologies (ART).  Since 1978 ART has been used to help infertile couples have children.  IVF is just one of many ART procedures.  The use of ART is often used for patients with advanced maternal age, delayed childbearing and often results in multiple births.  These all contribute to an increased risk of premature birth.  The Center of Disease Control (CDC) reported that 127,977 ART procedures were performed in 2004, with a resultant 49,458 live infants born.  The highest rate of ART procedures was in the state of California with 17, 303 performed.
• Advanced Maternal Age. Advanced Maternal Age (AMA) is considered any woman 35 years or older during pregnancy.  The rates of pregnancy for woman who are AMA is increasing, especially for woman ages 40-44.  Often times, these woman seek ART to achieve a pregnancy.  Some of the risk factors older moms may have that can lead to a premature delivery include: chromosomal abnormalities, gestational hypertension, intrauterine growth retardation, higher rate of cesarean section, chronic health problems and gestational problems.  Interesting side note, Nayda Suleman’s doctor implanted 7 embryos in a 49 year old woman, who is now pregnant, and hospitalized with quadruplets.
• Increasing Rates of Maternal Obesity. Maternal obesity can cause health problems in the mother that may increase the rates of prematurity.  These health problems include:  difficulty assessing gestational dates by ultrasound (this can lead to early  inductions or c-sections), hypertension, diabetes, fetal macrosomia, cardiovascular disorders and asthma.
• Increasing Rates of Multiple Births. Since 1980 there has been a 67% increase in the incidence of twins, and a 500% (!) increase in the rates of triplets and other higher order multiples.  Art procedures have been around since 1978, you do the math. The higher the amount of fetuses in one womb, the higher the chance of prematurity (and at lower gestational ages).  Multiples have a higher incidence of intra uterine growth retardation, discordant growth (a 20%  or greater difference between fetal rates-btw, the octuplets weights all varied greatly), and low birth weight, which can all lead to prematurity.  Pregnant mom’s of multiples may have the added health risks leading to premature birth, such as, gestational hypertension, diabetes, abruptio placenta and maternal hemorrhage.
• Other Risk Factors Include:
• Having a previous preterm labor or premature birth
• Problems with the uterus, cervix or placenta
• Smoking cigarettes, drinking alcohol or using illicit drugs
• Some infections, particularly of the amniotic fluid and lower genital tract
• Multiple miscarriages or abortions

Regardless of how you feel about Nayda Suleman and the octuplet saga, it has put attention on premature birth.  Prematurty is a major, preventable health problem that needs to be addressed.  The cost to our society, and more importantly the infants themselves, is too high a price to pay.

RR