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March 2007

Preterm Birth: The Leading Cause of Newborn Death in the United States

Preterm birth is one of the most common, costly and serious problems that face American infants today. Preterm is defined as birth prior to 37 weeks gestation, and it affects more than 500,000 babies in the United States every year. According to Dr. Jennifer L. House, President of the March of Dimes, recent government data shows preterm birth as the leading cause of newborn deaths
in the U.S.

In January 2006, Congress passed the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act (PREEMIE Act). The purpose of this act was to:

  • Reduce rates of preterm labor and delivery
  • Work toward an evidence-based standard of care for pregnant women at risk for preterm labor and infants born preterm and at a low birth weight 
  • Reduce infant mortality and disabilities caused by pre-maturity

The March of Dimes has commended Congress for approving this bill to help decrease the health and economic consequences of premature birth as well as increase federal support for research and education on prematurity.

Preterm birth causes too many cases of disability and death. The emotional impact on families and the financial impact of premature births were brought sharply into focus during a report from the Institute of Medicine. This report found that preterm birth cost the U.S. more than $26.2 billion in 2005 in medical care, lost household and labor market productivity and early intervention services. Researchers at the University of Pittsburgh found that women who become pregnant in spring are more vulnerable to preterm birth than those who conceive in other seasons. In fact, women conceiving in summer or fall had a 25 percent reduction in risk over those who conceived in winter or spring. Unfortunately, the underlying cause of premature birth still remains poorly understood.   

Education is crucial in the prevention of preterm birth, not only for your patient but for your practice as well. If you and your staff are well-educated on preterm birth, how to prevent preterm birth and the warning signs of preterm labor, you will be able to better inform your patients on how to recognize these signs and symptoms as well as what to do if they occur. 

Every pregnant woman must be considered at risk for a preterm birth. It is suggested by the March of Dimes that all women around the 20th week of their pregnancy should learn the signs and symptoms of preterm labor and how to respond. Make sure your staff and patients are educated on all of the following:

To help prevent preterm birth:

  • Know the warning signs of preterm labor
  • Continue with regular prenatal checkups
  • Reduce stress
  • Don’t smoke, drink alcohol or use illegal drugs—avoid secondhand smoke
  • Notify the health care provider if you feel burning or pain when you urinate—you could have an infection that increases the risk of
    preterm birth

The warning signs of preterm labor are:

  • Contractions (teach your patients that they occur when your abdomen tightens like a fist every 10 minutes or more)
  • Change in vaginal discharge (leaking fluid or bleeding from your vagina)
  • Pelvic pressure (the feeling that your baby is pushing down)
  • Low, dull backache
  • Cramps that feel like menstruation
  • Abdominal cramps with or without diarrhea

Important information to tell your patients:

  • Inform them to call the office, health care provider or go to the hospital right away if they think they are having preterm labor or if they have any of the warning signs
  • Let them know that they may be told to either come into the office or go to the hospital for a checkup
  • Stop what they are doing and rest on their left side for one hour
  • Drink 2-3 glasses of water or juice (not coffee or soda)

Inform them that if the symptoms don’t go away or get worse after one hour, they need to call the office or health care provider again, or go to the hospital. The same is true if the symptoms stop and then come back again.

Assessing your patients for the following high-risk factors of preterm birth is important. It is also more important than ever to educate and help your patient understand if they are high-risk so they are able to recognize the signs and symptoms of preterm labor and know how to respond if they occur.

Your patients are at high risk of preterm birth if they:

  • Have had a previous preterm birth
  • Are pregnant with more than one child
  • Have certain uterine or cervical abnormalities

Prenatal care is vital to help ensure a healthy delivery for the mother and child, but putting a comprehensive risk management system into place, from prenatal care to home care, is also essential. Briggs Maternal/Newborn Record System (MNRS) extends beyond the management of patient care by simplifying the documentation process of the patient’s initial and continuing health risk status throughout the entire pregnancy. In addition, MNRS allows you to capture the critical components of patient care necessary for good pregnancy outcomes, such as the patient’s genetic history, use of street drugs, use of tobacco and alcohol, the need for education and medical or psychosocial assessments. 

To learn more about Briggs MNRS, click here. To view samples of Prenatal Health History Forms, click here.

Transitioning to electronic documentation? Click here to check out Briggs NEW eMNRS product licensing.

Sources
www.marchofdimes.com/prematurity/5194_5221.asp
www.medpagetoday.com
www.upmc.com/Communications/SMFMSeasonalRelease.htm
Healthcare Daily Data Byte 2/13/07:Preterm Birth www.hin.com

Phyllis Bouley, LPN, AS
Clinical Project Consultant, Briggs Corporation

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