Preemies

The price of a drug used to delay birth in women at high risk of delivering prematurely is going to skyrocket following Food and Drug Administration approval of a prescription form of the product, a synthetic form of the hormone progesterone. Since 2003, the American Congress of Obstetricians and Gynecologists has recommended that doctors offer the progesterone shots to high-risk women. But because there has not been a commercial product available, women have obtained the drug from so-called compounding pharmacies, which make it to order.

The price of a drug used to delay birth in women at high risk of delivering prematurely is going to skyrocket following Food and Drug Administration approval of a prescription form of the product, a synthetic form of the hormone progesterone. Since 2003, the American Congress of Obstetricians and Gynecologists has recommended that doctors offer the progesterone shots to high-risk women. But because there has not been a commercial product available, women have obtained the drug from so-called compounding pharmacies, which make it to order.

One out of every 10 births today is premature. That means that many parents are thrust into a world of medical complexity and emotional turmoil few are prepared for. This book, by two journalists who gave birth to premature babies and by the neonatologist sister of one of the journalists, is a compendium of the issues that parents of preemies need to know. "Every day we needed more information, and the conversations with doctors and nurses were never enough," the mothers of the preemies write.

Nearly 1 in 10 of the world's babies is born prematurely, and about 1 million infants die each year as a result of premature birth, according to a report released Sunday by the March of Dimes. The problem is concentrated in poor countries, with the vast majority of the nearly 13 million preemies born each year in Africa and Asia, the report says. Although Africa has the highest rate of premature births, North America isn't far behind. Why? "That's the 13-million-baby question," said March of Dimes epidemiologist Christopher Howson, who headed the project being debated this week at a child health meeting in India.

Subnormal head growth during just the first six to eight months of small premature babies' lives may warn of irreversibly reduced intellectual ability, a new research study concludes. And while several experts agree that small head size in tiny preemies is only a risk factor--not a guarantee of diminished intelligence--the finding underscores yet another complication brought on by advances in medicine: Survival rates for the tiniest of newborns--those weighing between 15 ounces and 2.

Nearly 1 in 10 of the world's babies is born prematurely, and about 1 million infants die each year as a result of premature birth, according to a report released Sunday by the March of Dimes. The problem is concentrated in poor countries, with the vast majority of the nearly 13 million preemies born each year in Africa and Asia, the report says. Although Africa has the highest rate of premature births, North America isn't far behind. Why? "That's the 13-million-baby question," said March of Dimes epidemiologist Christopher Howson, who headed the project being debated this week at a child health meeting in India.

Another Mother's Day has come and gone, and for this I'm grateful. While I look forward to spending time with my loved ones, part of me wants nothing more than to retreat inward. It's not that I have anything against buffet brunches and lily corsages, but in my family this national day of recognition has come to take on a more personal meaning, standing as a gateway between our greatest joy and deepest sorrow.

Yes, yes, it hath charms to soothe a savage breast (or beast, if you prefer to repeat a common mistake). But researchers are finding that music may be an effective balm for many other afflictions: the isolation of conditions such as autism and Alzheimer's disease, the disability that results from stroke, the physical stress of entering the world too early. The hope of music's curative powers has spawned a community in the United States of some 5,000 registered music therapists, who have done post-college study in psychology and music to gain certification.

Premature babies grow better if they swing in a hammock rather than lie still in a crib, according to a new Dutch study. Fifty premature babies kept in hammock incubators in the first few weeks of life grew more and moved better than a control group of premature infants kept in regular incubators, the study at Utrecht's Wilhemina Children's Hospital showed.

Doctors can cut the risk of cerebral palsy in half for very premature babies by giving their mothers magnesium sulfate just before they give birth, researchers reported this week at a meeting of the Society for Maternal-Fetal Medicine in Dallas. The mineral compound, also known as Epsom salts, is already used to treat pregnancy-related high blood pressure and to stop early labor. Doctors should consider giving it to women about to deliver an extremely preterm infant, said one of the researchers, Dr. John Thorp of the University of North Carolina.

Doctors can cut the risk of cerebral palsy in half for very premature babies by giving their mothers magnesium sulfate just before they give birth, researchers reported this week at a meeting of the Society for Maternal-Fetal Medicine in Dallas. The mineral compound, also known as Epsom salts, is already used to treat pregnancy-related high blood pressure and to stop early labor. Doctors should consider giving it to women about to deliver an extremely preterm infant, said one of the researchers, Dr. John Thorp of the University of North Carolina.

Pregnant white women who have abnormally low cholesterol levels are 21% more likely to give birth preterm, and both white and black women with low levels give birth to babies who weigh less than other infants of the same gestational age, researchers report today. Obstetricians already knew that women with the highest cholesterol levels are more likely to give birth preterm, but this is the first evidence of risk at the other end of the spectrum, experts said.

Very small newborns who receive caffeine to help their lungs develop are less likely to need additional oxygen by age 3, a study published in the May 15 issue of the New England Journal of Medicine has found. Most babies born less than 34 weeks after conception periodically stop breathing for at least 15 seconds, suffering a condition known as apnea of prematurity. Caffeine is already widely prescribed for premature infants because of its ability to stimulate breathing.

Treating premature babies with nitric oxide gas improved their cognitive function at age 2 and lowered their risk of developing neurological complications such as cerebral palsy, according to a study published today in the New England Journal of Medicine. But a separate study concurrently published in the journal reported that the therapy did not help survival in a group of smaller and sicker premature babies and may have even worsened it in the sickest infants.

A baby girl who weighed 11 ounces at birth has died in Oklahoma City, a little more than three days after being delivered three months premature. Kalea Lyn Allen Richardson had been kept under a humidification tent in the neonatal care unit at Mercy Health Center. "She was my angel, and she was a fighter," said her mother, Deidra Allen. "We fought hard for her, and she made it until she couldn't make it anymore."

Her legs are no longer than an adult's pinkie and her feet are about the size of an adult's fingernails. Weighing 11 ounces, Kalea Lyn Allen was delivered three months premature Tuesday by caesarean section after an ultrasound raised concerns, Dr. John Stanley said. "She's a survivor," said her mother, 27-year-old Deidra Allen of Sayre. "She's fighting." The infant has about a 40% chance of survival and the first six weeks will be the toughest, doctors said.

Very small newborns who receive caffeine to help their lungs develop are less likely to need additional oxygen by age 3, a study published in the May 15 issue of the New England Journal of Medicine has found. Most babies born less than 34 weeks after conception periodically stop breathing for at least 15 seconds, suffering a condition known as apnea of prematurity. Caffeine is already widely prescribed for premature infants because of its ability to stimulate breathing.

For twins Andrew and Amber, the first 15 months of life have been hard. Born nine weeks early and weighing a bit more than three pounds each, they spent their first six weeks in intensive care at Childrens Hospital in Los Angeles. The next five months, although at home, they were hooked up to monitors with alarms because their prematurity made them susceptible to heart and respiratory illnesses.

When Rumaisa Rahman was born at Loyola University Medical Center in September, she weighed less than a can of soda and fit into the palm of her father's hand. A mere 8.6 ounces, she was believed to be the world's smallest surviving premature baby. Now, after more than three months in the hospital, Rumaisa is 2 pounds, 10 ounces -- big enough and healthy enough to go home soon, doctors said at a news conference Tuesday. Her original due date was Christmas Day.

The smallest premature babies, already at high risk of brain damage, are likely to develop even more mental disorders if they get any infection in the first weeks of life, researchers said. The babies face increased chances of brain injury and ailments such as cerebral palsy, according to a study by the National Institute of Child Health and Human Development. The study of more than 6,000 extremely low-birth-weight infants is in this week's Journal of the American Medical Assn.