For Release: March 25, 2010
Contact: Pamela Williams
Office of Communications
Preterm Births Cost Lives and Mounting Medical Expenses
One in Eight Oklahoma Families Impacted
Preterm births in Oklahoma are a public health crisis. According to the Oklahoma State Department of Health (OSDH), preterm births impact more than one in eight Oklahoma families.
Preterm infants face an increased risk of lifelong health consequences such as breathing and feeding problems, cerebral palsy, and learning problems. Besides health costs, there are the emotional and human costs that also take their toll on families.
In 2007, national statistics show the costs associated with the birth of an infant including in-hospital care, outpatient visits, and prescriptions for mother and baby averaged $15,047 for a baby born at term. However, if the baby was born preterm, the average cost rose to about $64,713 per birth. In Oklahoma, there are almost 6,000 babies born preterm, costing an estimated $300 million annually (based on 2007 costs).
“Preterm birth is the leading cause of death in the first month of life, which is tragic for families, communities and the entire state. We know that assisting mothers in getting healthy before they become pregnant can help them have a better pregnancy and prevent many preterm births,” said State Health Commissioner Dr.Terry Cline. “It will take more than an individual effort, however, to aggressively work on reducing preterm births in Oklahoma. To produce a healthier population, we must take a serious look at changing policies, improving provider services and payments, and increasing community outreach.”
Currently, Oklahoma’s infant mortality rate of 8.0 deaths per 1,000 live births is higher than the U.S. rate of 6.7 deaths per 1,000 live births. “This can and must change,” Cline said.
A birth is considered preterm if it occurs prior to 37 completed weeks of gestation. Infants born prior to 34 weeks gestation are considered “early” preterm deliveries, while infants born between 34 weeks and 36 weeks and 6 days are considered “late” preterm deliveries.
A recent Oklahoma Pregnancy Risk Assessment Monitoring Study (PRAMS) conducted by the OSDH, revealed the following:
- Socioeconomic status was an important predictor of preterm births. Women lacking a high school education and women who were not covered by private insurance were at higher risk of early preterm birth than more educated women or those with private insurance.
- Women receiving recommended levels of prenatal care were less likely to deliver preterm than women who had less than recommended levels of prenatal or no prenatal care.
- In agreement with prior studies, smoking during the last three months of pregnancy was moderately associated with a higher risk of early and late preterm birth.
- African-American mothers were twice as likely to have an early preterm birth compared with white and Native American mothers.
- Almost one in four births to women with a history of preterm labor were early or late preterm (8.91percent and 13.13 percent respectively), supporting national data indicating a history of preterm labor is a strong predictor of preterm delivery.
Some of the PRAMS recommendations include:
- Advocate for the provision of preconception care in all health insurance packages for all females and males of reproductive age and promote preconception care as a necessary piece of medical care. Preconception health care looks at medical, behavioral and social risk factors in order to improve the woman’s health and help reduce risks to her future baby. Educate health care providers to view every interaction with a female or male of reproductive age as an opportunity for preconception health counseling.
- Include special attention on informing and promoting the health of females of reproductive age – especially African American and Native American women -- in efforts such as Turning Point and other community-based coalitions focused on the issues of tobacco use and obesity.
- Support implementing an Oklahoma Maternal-Infant Quality Care Collaborative among Oklahoma perinatal care providers and hospitals with obstetric services and other partners to ensure that mothers and newborns receive safe, high-quality perinatal care. This would be accomplished by identifying and removing barriers to providing safe, quality perinatal care; providing comprehensive, evidenced-based education, best practice resources and patient educational resources; and collaborating to standardize perinatal care across the state.
- Formally designate levels of neonatal care in Oklahoma hospitals to clarify what equipment, facilities and staff are required to care for certain types of mothers and newborns. Decisions regarding delivery and transfers of mothers and newborns can be made according to designations.
- Challenge private and public stakeholders to participate in the Fetal and Infant Mortality Review (FIMR) Projects based in the major metropolitan areas of Oklahoma City and Tulsa by becoming involved in activities and projects that are based on or result from the Case Review and Community Action Team process.
- Educate mothers with previous poor birth outcomes, such as infant death, premature labor, and pre-existing medical conditions, to ask for appropriate referrals to specialists before becoming pregnant.
- Enhance the perinatal telemedicine network for rural women with high-risk pregnancies, with a particular focus on Native American and African American women in rural areas of the state.
To read the entire PRAMS article visit: http://www.ok.gov/health/documents/PRAMSGRAM_Prematurity_Vol13_No3_Summer09.pdf .
For more information on the OSDH initiative to reduce infant mortality and help parents have healthier pregnancies and babies, view the “Preparing for Lifetime, It’s Everyone’s Responsibility,” initiative at Web site: http://iio.health.ok.gov.