Research documents medical consequences, costs of preterm births

By Jim Killackey

Published: July 14, 2006

Kennedy Dawn Stanfill lived three days, 16 hours and three minutes after she was born 17 weeks prematurely in December at an Oklahoma City hospital.

A mere 1 pound and 8 ounces, she seemed fine for 24 hours, but her medical condition quickly worsened.

March of Dimes
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Her underdeveloped lungs and respiratory system were strained to the point that Kennedy was put on a ventilator, her mother Kerri Stanfill said.

The baby girl had internal bleeding and an unknown infection. She required blood transfusions and her right lung collapsed.

As her condition spiraled downward and the end neared, all hospital monitors, tubes and lines were removed so Kerri and husband Marcus Stanfill could hold their daughter in their arms as she died.

“We had four amazing days with our baby,” Kerri Stanfill recalls. “Some parents don’t even have that.

“Sometimes there just aren’t happy endings,” the Del City woman said of her premature pregnancy.

The medical consequences and extraordinary medical costs associated with prematurity are documented in a national study released Thursday.

Birth rates escalating
The study by the Institute of Medicine of the National Academies reports that 50,000 premature births annually in the United States constitute a public health crisis that costs the country $26 billion a year.

The study noted troubling disparities in preterm birth rates among racial and ethnic groups. It recommended research to improve the prediction and prevention of preterm births.

In Oklahoma, more than 6,300 of the state’s 50,000 babies are born prematurely each year, according to the March of Dimes.

Premature births are considered by the March of Dimes as the top obstetric problem in Oklahoma and the nation.

It is the leading killer of newborns, and a major cause of health problems later if the babies survive, said Dr. John Stanley, a maternal fetal medicine specialist in Oklahoma City.

“Premature birth can happen to any pregnant woman, and in many cases no one knows exactly why it occurs,” he said. “It is a serious, common and costly problem that affects a lot of people in Oklahoma.”

Medical costs in Oklahoma easily can exceed $1 million for each premature baby born, he said.

Causes of premature births can include smoking, physical and emotional stress, hormonal imbalances and the age of the mother, according to Oklahoma doctors.

A lack of adequate prenatal care, alcohol and unprescribed drugs also are blamed for premature births.

Every day, one in eight U.S. babies arrives too soon, and premature birth rates are escalating annually, according to the March of Dimes.

“This problem goes on and on and on,” said Dr. Stanley. “And premature babies have a huge impact on families who grieve and infants who face long-term medical difficulties.”

Hundreds die after birth, and the official cause of death is usually respiratory distress or cardiac failure, said Belinda Rogers with the March of Dimes Oklahoma chapter.

“You do everything right, but it still happens,” Rogers said.

Underdeveloped lungs and weak immune systems “leave these fragile patients susceptible to respiratory illnesses,” Rogers said.

Babies born prematurely can have cerebral palsy, blindness, low blood pressure, a breathing difficulty known as apnea and other ailments.

No reason apparent
Aftyn Wooly of Ardmore was born seven weeks early and transferred by helicopter to St. Francis Medical Center’s neonatal intensive-care unit in Tulsa.

He spent three days on a ventilator and then was given the drug Surfactant, which forced his tiny lungs to open up and take air in and push it out, said his mother, Melissa Wooly.

Back at home in Ardmore, an “apnea monitor” uses electrodes on each side of Aftyn’s chest to measure his breathing. If he goes more than 45 seconds without breathing, an alarm sounds.

Melissa Wooly said she wants Oklahoma mothers to take all necessary precautions to avoid a premature birth. But parents shouldn’t feel guilty if it happens for no apparent reason, she said.

“I don’t smoke, I don’t drink, I took my vitamins and made all of my doctor appointments during my pregnancy,” Wooly said. “I couldn’t imagine doing anything that would increase the risks of a premature birth.”

One major risk is having multiple births from a single pregnancy, and Melissa Middleton of Oklahoma City gave birth to quadruplets June 10, 2003.

Benjamin, Donovan and Callie survived, but an infection led to a blood clot that took the life of Alexander.

Benjamin Middleton is blind in his left eye and visually impaired in his right eye.

Multiple births blamed
The Institute of Medicine of the National Academies’ report recommends that guidelines be issued to further reduce the number of multiple births - a significant risk factor for preterm birth - resulting from infertility treatments.

Melissa Middleton, now part of a March of Dimes family support group, wants all pregnant women to understand the symptoms, possibilities and dangers from premature births.

“If you feel something isn’t right, it probably isn’t,” Middleton said. “Listen to your body.”

Pregnant women shouldn’t feel hesitant or embarrassed to mention to their doctors the possible symptoms of a premature birth.

Symptoms include cramping and contractions after 20 weeks of pregnancy, feeling the uterus tightening and excessive vaginal bleeding.

Kerri Stanfill, 32, is working with the March of Dimes to try to keep other Oklahoma parents from having the pressure-packed experience of a premature baby.

A fourth-grade teacher at Fisher Elementary School in Moore, Stanfill plans to coordinate a March of Dimes “coin drive” at 20 Moore grade schools to raise funds for March of Dimes’ efforts supporting research to reduce premature births.

A state “Premature Awareness Day” is scheduled for Nov. 14, she said. During November, night lights at the state Capitol will be pink and blue to call attention to the problem, she said.