Babies Born Even a Few Weeks Early Face Higher Risk
The babies born between 34 and 36 weeks fared better, but the risk of death during the newborn period or first year of life was still four-and-a-half times higher.
Along with deaths from infection, deaths from asphyxia, sudden infant death syndrome, and abuse were also higher. As with infection, Kramer and his team found that the first month of life was most critical.
Sadly, their findings also showed that little has changed in the patterns of death in either Canada or the United States since 1985, except for a decreased risk of death associated with infection. Kramer writes that "preventing the occurrence of mild and moderate preterm births and of death among such births remain worthy targets for future research and clinical intervention."
"It's obvious from this latest data that preterm birth is still a problem," Robert C. Cefalo, MD, PhD, tells WebMD. As a result of these findings, he says, women contemplating pregnancy or at risk for preterm birth should work with their clinicians to "avoid preterm labor and delivery" whenever possible. Cefalo is clinical professor in the department of obstetrics and gynecology at the University of North Carolina School of Medicine at Chapel Hill in North Carolina. He is also a pioneer in maternal-fetal medicine, the subspecialty dealing with pregnancy complications.
But is this a cause for alarm about any baby born early? Charles R. Rosenfeld, MD, director of neonatal-perinatal medicine at the University of Texas Southwestern Medical Center in Dallas, helps put the numbers in perspective.
"Our institution has the largest delivery rate in North America, with close to 16,000 babies a year," he tells WebMD. "Of that group, about 100 babies a year are less than 30 weeks gestation." About 500 to 600 of those babies are born between 32 and 36 weeks, he says, and "at 36 weeks gestation, we don't even put them in our neonatal care unit -- their survival rate is 95%." Rosenfeld is also professor of pediatrics and obstetrics-gynecology.
However, Mark A. Klebanoff, MD, MPH, director of the division of epidemiology statistics and prevention research at the National Institute of Child Health and Human Development in Maryland, tells WebMD: "These babies are not the same as full-term babies, and they still account for more than their share of infant mortality." Still, when it comes to the question of inducing labor, he says, "If a woman is having a complication, it becomes a question of weighing the risks of continuing the pregnancy vs. having the baby now."