Word: preterm
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Zach represents what used to be the cutting edge in pediatrics: the heroic effort to keep younger and younger babies alive. Today neonatal specialists can ensure the survival of up to 95% of infants born preterm. But as Dr. William Callaghan of the Centers for Disease Control and Prevention's Division of Reproductive Health puts it, "We're reaching down to the limits of our viability." That is why he, like many other experts in the field, is advocating a shift in focus from survival to prevention...
...approach in action at the University of Kentucky's Chandler Medical Center in Lexington, one of six hospitals to be named this week as lead participants in a 3 1/2-year, $1.5 million joint project aimed at reducing preterm birth, sponsored by the March of Dimes and the Johnson & Johnson Pediatric Institute...
...change in philosophy comes not a moment too soon. Preterm births account for more than a third of all infant deaths in the U.S. and cost Americans $26.2 billion a year. And although many of the half a million preemies born in the U.S. each year go on to live long, healthy lives, for too many the problems of their entry into the world are compounded by long-term complications ranging from mental retardation and cerebral palsy to hyperactivity and respiratory disorders. "We all bear the costs," says Dr. RuthAnn Shepherd, director of the Kentucky department of health's division...
...reasons Kentucky was singled out for special attention is that its rate of preterm births--1 in 7--is one of the highest in the nation. The Chandler Medical Center's is even higher, a stunning 27%. But that's in large part because so many high-risk patients are transported to its state-of-the-art NICU facility, designed to accommodate the most vulnerable newborns. Like many other teaching hospitals, the medical center could be viewed as a victim of its success. But Dr. James Ferguson, chair of the University of Kentucky's department of obstetrics and gynecology...
...focus is on the nuts and bolts of a healthy pregnancy: screening for bacterial infections, watching for signs of domestic violence, discouraging alcohol consumption, encouraging smoking cessation (1 in 4 pregnant women in Kentucky smokes), monitoring weight gain and nutritional intake and, when necessary, giving drugs to prevent preterm labor. Weekly injections of a progesterone-based drug after week 16, for example, can reduce the recurrence of premature births by one-third...