Doctors puzzled by
more premature isle
birthsA summit will discuss ways to
decrease this costly problem
Hawaii's birth rate is going down while the number of premature babies is going up, according to national statistics.
The trend and effects of premature birth will be discussed at the first Prematurity Summit sponsored by the March of Dimes Hawaii Chapter from 4 to 7:30 p.m. tomorrow at the Kapiolani Medical Center, second floor auditorium.
Connie Brunn, the chapter's program services director, cites data reported by the National Center for Health Statistics showing the decline in births and rise of premature babies.
Hawaii had 17,341 births in 1996, of which 1,853, or 10.7 percent, were born preterm (less than 37 weeks from conception to birth), she said. In 2001, isle births totaled 16,951 with 2,163, or 12.8 percent, preterm.
Dr. Sherry Loo, neonatologist at Kapiolani Medical Center for Women and Children, said the percentage of premature births "dwarfs the number of new cases of breast cancer, TB, AIDS and all other high-profile problems having awareness campaigns."
There is no known cause, she said, adding that there are a number of possibilities, but they haven't been investigated.
"Because health care costs are related to prematurity, families are impacted and the potential effects are long term," Loo said. "They don't end when a baby is discharged from the hospital."
She said a premature birth means subtle differences may occur in a baby's development about which specialists aren't really knowledgeable.
But it is known that children born too early have more problems with learning and developmental delays at school age and they may have long-term neurosensory deficits, she said.
The spectrum of prematurity ranges from 24 to 36 weeks, Loo said. "The 36-weekers don't have too much effect. They go home in a week. The ones very premature, at the lower limit, 24 to 25 weeks, may have many complications. They may be in the hospital three to six months longer."
All March of Dimes chapters are participating in a campaign to reduce premature births by 15 percent in the next five years, Loo said. "It's not really an ambitious target when you think we're just trying to get down to baseline."
Brunn said the March of Dimes wants to make sure people are aware of the problems of premature births.
Surveys conducted on the mainland found a lot of people knew someone with a premature baby but didn't see it as cause for concern, she said.
"The reality is, in 25 percent of cases, they're not OK. We also want people to be aware in 50 percent of the time there is no known risk factor. Mom can do everything right, so it's not her fault if she goes into preterm labor."
Another perception was that premature births aren't a big deal any more because of medical advances, she said. "The reality is more are happening now than there used to be and we don't know why. ... Because we don't know the cause, it's almost impossible to prevent."
Brunn said March of Dimes wants to make sure pregnant women know the signs and symptoms of labor and when to call the doctor. Some treatments are available once a woman goes into labor that can somewhat stall labor but they don't always work, she said.
The organization also wants to increase fund-raising throughout the country for research into the causes of preterm labor and treatment, she said.
Dr. Scott Berns, pediatrician and vice president of March of Dimes chapter programs from White Plains, N.Y., will be keynote speaker at the summit.
Also speaking will be Loo; Dr. Ken Ward, new chairman of the Department of Obstetrics/Gynecology at the University of Hawaii John A. Burns School of Medicine; Kapiolani perinatologist Greigh Hirata; and Cheryl Prince of the state Department of Health.
Brunn said the increased numbers of premature births should be of concern to everyone because of financial and emotional costs.
She said the Hawaii Chapter, as well as Kapiolani, gets a lot of requests for air fare from neighbor island parents who want to visit premature babies at Kapiolani.
They may have other children at home and can't stay at the hospital with the new baby, but March of Dimes has no money for air fare and nobody else provides it, she said.
Space is limited for the Prematurity Summit, so reservations are requested. Call Brunn at 973-2152 or e-mail cbrunn@marchofdimes.com.
