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    Health Risks Trail Preemies to Adulthood

    Premature Babies at Increased Risk of Death, Have Lower Reproduction Rates as Adults, Study Shows

    Reproduction Rates Much Lower continued...

    Reproduction rates increased with gestational age, suggesting that the finding was not a matter of chance, Swamy says.

    The reasons for the associations seen in the study remain unknown.

    And it is not clear if babies born today face the same long-term risks as those identified in the study.

    The survival rate among babies born very prematurely continues to increase, thanks to medical advances and aggressive management.

    "We have better interventions to help babies survive, but we don't have better interventions to prevent preterm births," Swamy says. "We really need a better understanding of the causes of preterm delivery."

    Findings Cause for 'Cautious Optimism'

    Research epidemiologist Melissa Adams, PhD, MPH, of the research group RTI International says the study shows the importance of finding better ways to reduce premature delivery.

    "Every additional week of gestation is very important for reducing the risk associated with premature birth," she tells WebMD.

    In an editorial accompanying the study, Adams and Wanda Barfield, MD, MPH, of the CDC write that the findings should be interpreted cautiously.

    Barfield tells WebMD that the mortality findings are cause for "cautious optimism" because the survival disadvantage associated with preterm birth declines with age and the absolute risk of death after infancy is small among people born prematurely.

    March of Dimes Medical Director Alan Fleischman, MD, tells WebMD that the prognosis is generally good for babies born at 26 weeks of gestation or more.

    Babies born prior to this often have lifelong developmental issues, which can vary from mild to extremely severe.

    Because of this, the families of babies born at this threshold of viability need to be fully informed of possible outcomes and involved in decisions about how aggressive to be with medical interventions.

    "We have to respect the importance of family involvement in decisions about care for these sickest and smallest children, because their outcomes are so uncertain," he says.

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