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Nearly one out of every six African-American babies in the United States is born premature. In Newark, New Jersey it's one in five. I am a maternal-fetal medicine specialist, and every day I see women who are at risk of delivering early.

I remember, quite dearly, one young African-American woman who came for her first prenatal visit at seven months of pregnancy. She had a prior baby who was born prematurely in another state, and the baby did well. Overwhelmed by the thought of motherhood, she did not seek out any community resources and had only recently learned about our practice. She was complaining of abdominal pain when I saw her. Her ultrasound confirmed that she was 28 weeks. The baby weighed slightly over two pounds. I diagnosed preterm labor and sent her to the hospital for care. She delivered a live baby girl one week later. Although the baby was premature, our interventions, including medication and excellent care for the newborn, allowed her to take the baby home about eight weeks later.

Preterm birth is a serious and costly health problem, and unfortunately African-American babies have the highest preterm birth rate of any other racial or ethic group. African-American women are more than one and a half times as likely to have a preterm baby compared to white women. The reasons for these differences are still under investigation, and actions to reduce the preterm birth rate in this population are underway.

In Newark, the March of Dimes, local health officials, and Johnson & Johnson launched Healthy Babies are Worth the Wait®, a community-based program to help give more babies a healthy start in life.

The Healthy Babies are Worth the Wait program is a preterm birth prevention initiative. It provides education for pregnant women, health care providers and the community about the serious long term health consequences of an early birth, the risk factors for preterm birth and strategies for reducing that risk.

There are things a woman can do to help give her baby a healthy start in life and reduce her risk of having a preterm baby.

These are five of the ways to increase the chances of having a healthy baby:

1. Arrange a preconception check-up with a health care provider before getting pregnant to make sure you are in the best heath possible.

2. Seek early prenatal care. All women should visit with their health care provider as soon as pregnancy is recognized so that their pregnancy can be managed. Women who have already had a preterm infant may be candidates for interventions that can reduce the chance of having another premature baby.

3. Manage your medical problems. Women with diabetes, hypertension or other medical problems should plan their pregnancies. Work with your doctor to first get these conditions under control before attempting pregnancy.

4. Manage medications. Women who take medications should make sure that any medication they are taking is safe in pregnancy.

5. Develop healthy habits. Avoid stress, tobacco, alcohol or the use of other illicit drugs. Take a multivitamin with folic acid every day to reduce the chance of birth defects. Eat properly and get to a healthy weight.

Preterm birth is the leading cause of newborn death. Babies who survive an early birth face an increased risk of life-long health consequences, such as breathing problems, cerebral palsy, learning disabilities and other conditions. Every week of pregnancy is crucial to a newborn's health, and babies do much more than gain weight during the last few weeks of pregnancy.

Important organs, such as the lungs and brain, are still developing. In fact, at 35 weeks of pregnancy, a baby's brain weighs only two-thirds of what it will weigh at 39 to 40 weeks. Through education, interventions, and strengthening community resources, the Healthy Babies are Worth the Wait program aims to reduce preterm birth. My hope is that African American moms such as the one that I described - and indeed, all moms - have healthy full-term infants. Certainly, "Healthy Babies are Worth the Wait."

Click on these links to learn more about Healthy Babies are Worth the Wait-Newark, preterm birth, and the New Jersey Medical School Obstetrics department.

 

Follow Lisa Gittens-Williams, M.D. on Twitter: www.twitter.com/@MarchofDimes

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05:46 AM on 05/03/2012
In urban Memphis, Tennessee's safety net hospital - The Regional Medical Center at Memphis - nearly 4 in 10 of our 5000/year deliveries are premature. One in 10 deliveries is less than 28 weeks gestation; 3 in ten is between 28 and 37 weeks gestation. Nearly 75% of the placentas from these early deliveries have signs of infection of the fetal membranes (usually a consequence of an untreated urinary tract or other genital tract infection) and blood pressure problems (pre-eclampsia).

Sadly, within some of our urban communities, there is a financial incentive to deliver prematurely. Many young pregnant women within our African American community speak openly about how delivering early will make the mom and the baby eligible for additional government assistance.

The consequences to the mothers for untreated infections are insufficient to offset both the lack of knowledge about the long term effects to the child of early delivery and the potential financial gain. Our facility routinely delivers babies to 13, 14 & 15 year olds. Quite often is that a 20 year old mother already has three children - and even more sad is that each is likely to have a different father. These are real problems within our urban African American communities.

In our communities where early pregnancy is common, and more than one father of each subsequent child is also common, and the financial incentive for a premature delivery is there - what incentive is there to these mothers to embrace "Healthy Babys are Worth the
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bornorange
Watching history repeat, sadly.
05:58 AM on 05/03/2012
Shocking! ... but so true.

30 years ago I knew a young black male (18) who proudly proclaimed that he had helped 4 different girls have kids... so they wouldn't have to work.

Apparently, the federal government and all the well-intended programs continue to have devastating "unintended consequences."
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Abmaj7
he who laughs last, thinks slowest
04:41 AM on 05/03/2012
Anyone notice that the only advice offered to prevent premature labor/delivery is to essentially "take care of yourself". The truth is that despite decades of research, clinical trials, drug protocol changes, and retrospective analysis, there is still NOT A DAMN THING that can be done to prevent premature labor or stop premature delivery once labor begins in earnest. Furthermore, there is NOT A DAMN THING that can be done to prevent preeclampsia, eclampsia, uteroplacental insufficiency, oligohydramnios, and a host of other conditions that once manifest, can only be treated by expedient delivery, regardless of gestational age. Rather disheartening
05:55 AM on 05/03/2012
Abmaj7 - Agree with your observations and am disheartened, too. As you likely are aware, pre-eclampsia is immune in nature. The lowest risk for pre-eclampsia is for the mother to have been exposed to the father of the baby's seminal fluid (and only his) for several months prior to pregnancy. The risk for pre-eclampsia increases with each new father of the baby. It only decreases with subsequent pregnancies by the same father. The prevention of pre-eclampsia, sadly, is one that is in the hands of the mother in who she chooses to become pregnant by.
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geauxangel
04:04 PM on 06/13/2012
You are right..the only thing we can do is educate pregnant woman about signs of infection or early labor so they can recognize the need to seek medical treatment if needed...poverty and ignorance increase the chances that something will go unchecked and ubtreated..this is true in all areas of illness and not just pregnancy...a lot of the time the baby will come early no matter what but if the mom is getting prenatal care then even an early baby has a chance.
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nikanj
free the fnords
03:38 AM on 05/03/2012
This is exactly why we need community-based health clinics staffed by public health nurses.
I would like to see one associated with just about every elementary school and staffed 24-7.
12:18 AM on 05/03/2012
I am from Newark, NJ.
Though I haven't lived there in years.
I still have family there.

I have lived in North Newark on Broadway and in the Roseville section.
I have family who have lived in the central ward and the Ironbound area.

I had 3 of my 4 kids in the old Municipal Hospital.....that was eventually replaced with University Hospital.
Yea, I remember the maternity wards and breast feeding was uncommon back then.

I KNOW the city.

And a lot of the problem is caused by women's lifestyles and women who don't seek early prenatal care.
It is not just a problem of black women either.
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tori griffith
09:58 PM on 05/02/2012
It's sad!
07:18 PM on 05/02/2012
Does anyone know if there are studies linking Vitamin D levels to pre-term deliveries? I am wondering if dark-skinned women are getting enough Vitamin D in climates that keep all of us indoors...
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TraceyES
05:58 PM on 05/02/2012
Oh, my goodness, the baby in that photo is SO beautiful...
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Cynthia Rays
peace in the valley seeker
02:33 PM on 05/02/2012
These are very sad statistics. It is hard enough to be a new parent but when your baby needs so much medical intervention it makes it much more difficult.
01:13 PM on 05/02/2012
I was born premature in 1957, After a few months in a incubator I came home, some of the problems are visual, but so very many are not. I know I look normal, yet so many things have been a difficult struggle. Many go undiagnosed and only recently have I started to understand why things are so difficult for me.
It is a lifelong sentence, all women and babies deserve prenatal health and support.
I do have a question for you as a Dr...... does anyone ever study the adult preemie? I have heard of many issues because of not getting some of the hormones in the latter months of gestation can cause.
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Florha Jones
Worship, workout & work !!!
12:45 PM on 05/02/2012
Inherent societal stresses have a major effect on premature birth rates....
12:01 PM on 05/02/2012
I am an Ob-Gyn. Even though we have the most expensive health care system in the world, we rank about 17th in peri-natal morbidity and mortality. Almost all of the countries that rank ahead of us have national health care systems. It is politically radioactive, but a national health care system put in place would improve the outcomes in this country.
09:58 AM on 05/02/2012
Good Luck Dr Williams! so many young women still want to pretend "pregnancy won't happen to me" so they live in denial and don't seek the care they should. Its disappointing that adequate sex education isn't always available or "interesting" to make an impression!
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Hellooo
08:23 AM on 05/02/2012
How do we know that these babies are preterm? Maybe we don't know what the term should be. Too many women don't keep good records on mentral cycles. Too much ignorance is spread around as facts. Too much effort to correct problems that (may) exist and not enough effort to correct real problems.
09:14 AM on 05/02/2012
Dr. Hellooo, actual doctors can tell how far along the infants are based on developmental markers and growth rates that occur reliable gestational points.
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Sally Tallywhacker
Godless, just like everyone else.
10:43 AM on 05/02/2012
Seriously?

Are you female ?
07:37 AM on 05/02/2012
I agree.