A recent interview with Medical News Today features neonatologist Dr. Charleta Guillory talking about her experiences caring for very small babies, how health inequity affects prematurity, and the public health measures she has put into place to combat these problems.
Those Premature Babies: Who Will Stand Up For Them?
Premature births account for 10% of births in the United States each year, meaning that babies are born before 37 weeks of pregnancy. The number of premature births worldwide is estimated at 15 million per year. The medical advances that have reached us over the last few decades have helped many babies born prematurely survive and have good long-term outcomes. However, prematurity remains the number one cause of death for children under five worldwide.
Dr. Charleta Guillory, the Director of the Neonatal-Perinatal Public Health Program at Texas Children’s Hospital as well as an associate professor at Baylor College of Medicine, was the subject of a Special Feature interview by Medical News Today. The March of Dimes previously employed Dr. Guillory as its prematurity campaign director for Texas State.
The interview took place while Dr. Guillory was on call at Texas Children’s Level 4 neonatal intensive care unit (NICU), where he was on call for the next 6 weeks. In NICUs at Level 4, babies who are premature or critically ill receive the highest level of care. Small infants weighing between 750 grams and 1,500 grams – those who were born before 32 weeks – are cared for in this department.
Throughout the meeting, Dr. Guillory discussed the factors associated with prematurity and the factors that lead to prematurity. During the COVID-19 pandemic, she explained how her unit and the families she is working with have managed the care of premature babies. A long-term outlook was discussed, how she speaks with parents, and what family and friends can do to support the babies.
As part of her presentation, Dr. Guillory talked about the main social determinants of health that contribute to prematurity, and what public health measures she has developed to address them. Clarifications have been made to the transcript of the interview.
The rate of premature births is on the rise
When healthcare professionals refer to a baby as premature, what does this mean exactly?
Preterm birth is delivered before a woman has completed 37 weeks of gestation. This is what the American Academy of Pediatrics (AAP) defines as preterm.
There are three types of preterm births: late preterm and moderate preterm births. Either of these is born within the 34th week or 36th week and 6 days of gestation. Very preterm births are those born less than 36 weeks of gestation. Every 10th U.S. birth occurred during preterm labor in 2019, which is a frightening figure.
The Centers for Disease Control and Prevention (CDC) shows that premature birth rates decreased from 2007 to 2014. The research conducted by CDC indicates that the low number of births to teens and young mothers is likely to be attributable to this. CDC statistics reveal that 14.4% of African American women gave birth to a preterm infant in 2019. Preterm birth rates are nearly 50% higher among white women than among Hispanic women.
Are risk factors specific to your situation? Premature births are more common in whom?
Dr. Guillory: Sociodemographic factors and obstetric factors are both associated with preterm birth.
A history of preterm birth, as well as maternal age, are among the maternal reproductive factors. It is observed that maternal age and preterm birth frequency exhibit a U-shape relationship. The preterm birth rate is higher among women between 21 and 24 than among those under 16 and over 35. It is equally important to take care of a mother. We discuss infections, anemia, hypertension, preterm labor, eclampsia, cardiovascular and respiratory disease, as well as diabetes.
Furthermore, there are issues related to maternal lifestyles, such as physical activity, smoking and substance abuse history, diet, weight, and stress. The placenta, uterus, and cervical factors also come into play, including a short cervix, cervical surgery, uterine abnormalities, vaginal bleeding, and placenta previa or abruption.
The risk of having more than one baby increases if you carry more than one pregnancy. Several factors can contribute to fetal distress, including congenital anomalies, growth restrictions, fetal infections, and fetal distress.
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