Tenn. still has work to do on premature births
Dr. Robert Elder was sad, but not surprised, that March of Dimes gave Tennessee an “F” grade on its annual Premature Birth Report Card.
Elder, an obstetrician/gynecologist at the University of Tennessee Medical Center for 21 years, has seen the numbers of premature babies increase along with the means to treat them.
“Our care for (premature) children has increased dramatically,” Elder said, “but what we’d like to do is keep them in the uterus longer.”
March of Dimes released the report card Tuesday, giving the nation a “D” grade. No states got “A”s; only Vermont received a “B.”
The nonprofit looked at the percentage of babies born at less than 37 weeks’ completed gestation, the percentage of babies born 34-36 weeks’ gestation, the percentage of women 18-44 who smoke, and the percentage of women 15-44 with no health insurance coverage.
Tennessee also received a failing grade on last year’s report, which March of Dimes East Tennessee Executive Director Vickie Day called “unacceptable.”
But Day noted a glimmer of good news: The number of late preterm births (34-36 weeks) dropped three-fifths of a percent, and the number of women of childbearing age who smoke dropped from 26.6 percent to 21 percent. The number of uninsured women, however, rose more than 1 percent.
Tennessee’s prematurity rate, at 14.2 percent, is ninth among states. Elder said prevention includes aggressively monitoring women who have previously given birth prematurely (the “No. 1 risk for prematurity,” he said), along with smoking cessation, encouraging better and earlier prenatal care and teaching women to watch for signs and symptoms of unexplained conditions that could cause preterm birth, such as high blood pressure and preeclampsia. The March of Dimes funds both education efforts and research into conditions that can result in prematurity, Day said.
Dr. Mark Gaylord, director of the UTMC neonatology department, said the medical community has done a good job of educating mothers at high risk for prematurity that they need to be watched more closely. About 80 percent of premature babies in UTMC’s neonatal intensive care unit were born at the hospital and immediately taken to the NICU, rather than having to be transferred after birth, he said.
“It’s always better to transport the baby in the uterus” rather than to wait until after birth, Elder said.
Because doctors had already noted a problem with her placenta, Sarah Thomas was at UTMC when she gave birth to her son, Grey, at 24 weeks’ gestation in 2005. He weighed 14 ounces and spent months in the NICU.
“His eyes were fused; he had hardly any skin,” said Thomas, who had preeclampsia. “Our wedding rings fit around his leg.”
Now Grey is an energetic 4-year-old with a big appetite who likes reading, running around outside and playing with cars and robots.
“We’re just glad that he’s here,” Thomas said.
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