You know- some time ago we were talking about special education, and why there are so many more children IN it. I had forgotten that advances in preemie technology.
That's a good point. We should have thought of it earlier. I accept my share of responsibility for my failure to do so.
Here's some more on low birthweight babies.
Smaller Suburban Babies
Study Shows an Increase in Low Birth Weights
By Nurith C. Aizenman
Washington Post Staff Writer
Wednesday, August 7, 2002; Page B01
Low birth-weight babies have become increasingly prevalent in the nation's suburbs as more women have children at older ages and use procedures such as in vitro fertilization that are more likely to produce multiple births, according to a study released yesterday.
The study by researchers at the State University of New York Downstate Medical Center found that the suburban low birth-weight rate in the nation's largest 100 metropolitan areas rose more than 14 percent in the 1990s, from 6.1 percent of births to 7 percent, or 87,860 babies.
Although still lower than the 8.9 percent rate in cities, where low birth weight traditionally has been associated with conditions of poverty, the suburban rate rose nearly three times as fast.
"This really took us by surprise," said the study's lead author, Dennis Andrulis, a professor at SUNY Downstate Medical Center, in Brooklyn, N.Y.
The study, which was funded by the Robert Wood Johnson Foundation, compared the success of cities and their suburbs in meeting seven federal health goals, including lowering the rates of infant mortality, homicide and syphilis.
While many cities and suburbs fell short of those objectives, low birth weight was the only one for which city and suburban rates on average were higher at the end of the 1990s than at the beginning. And no cities, and only two suburbs, met the government's goal of a 5 percent low birth-weight rate.
Low birth-weight infants are defined as those born weighing 5 pounds 5 ounces or less. The median weight for newborns in the United States is 7 pounds 7 ounces.
The growing numbers of underweight babies in the suburbs is of concern, Andrulis said, because they are at higher risk of developing a host of disabilities, including cerebral palsy, autism, mental retardation and vision and hearing disorders. "This is a not-so-early warning sign about the health of our next generation," he said.
Washington's suburbs reflect the trend -- with the low birth-weight rate increasing from 6.4 percent to 7.5 percent, or 4,753 births, over the last decade. By contrast, the District's low birth-weight rate decreased from 15.1 percent to 13.1 percent, or 987 births.
The slower rate of increase of low birth weights in many cities may reflect efforts by local and federal public health officials to improve indigent women's access to prenatal care and to educate women about the risks of smoking while pregnant -- which significantly increases their chance of giving birth to an underweight child, said study co-author Lisa Duchon.
There are signs of progress: According to the U.S. Centers for Disease Control and Prevention, the percentage of women who smoked during pregnancy has declined by nearly 40 percent since 1989. Similarly, the infant mortality rate, which is affected by access to prenatal care, declined significantly in both cities and suburbs over the last decade.
But even as officials have celebrated these gains, a variety of developments are fueling an increase of underweight babies in the suburbs.
Among the most dramatic has been the advancing age at which women are having children. The percentage of women between 35 and 39 who gave birth increased by nearly 40 percent over the last decade to 4.04 percent in 2000.
The chance of having a low birth-weight baby increases substantially as a woman ages for a number of reasons, experts say. For instance, "older women tend to have more multiple births, and multiple births are much more likely to be born prematurely because there is only so much room in the uterus," said Mark Klebanoff, a director at the National Institute of Child Health and Human Development.
An increasing number of women who would otherwise have difficulty conceiving are also taking advantage of advances in reproductive technologies, which studies have shown roughly double the chance of delivering a low birth-weight baby.
About 29,000 children were born through such procedures in 1998 -- the most recent year for which statistics were available.
Authors of the SUNY Downstate Medical Center study cautioned that there may be additional, underexplored factors behind the rise in underweight babies in the suburbs -- including changes in the characteristics of suburban populations.
If the number of underweight suburban babies continues to grow, schools, workplaces and social service agencies across the nation could be affected.
There are already indications that suburban hospitals in the Washington area are adapting to the increase.
For years, Shady Grove Adventist Hospital in Rockville would refer women likely to give birth to underweight babies to District hospitals with neonatal intensive care units. But by 1996, Shady Grove was coming across enough cases to warrant opening an NICU of its own.
Since then, Anne Arundel Medical Center, Prince George's Hospital Center and Howard County General Hospital have followed suit.
Shady Grove, meanwhile, has seen the number of patients in its NICU rise from 400 a year to more than 700. The facility now resembles a bustling village for tiny people, with its inhabitants housed in row upon row of glass incubators decorated with photographs and blankets.
Beside one such dwelling, Susan Ostrinsky sat in a rocking chair on a recent evening, cradling her 3-pound son, Benjamin, as she fed him through a tube barely wider than a thumbnail.
The mixed emotions she felt as she looked down at him reflected both the promise and the predicament that underweight suburban babies represent.
On the one hand, she had much to be thankful for. Three years ago, after years of searching, she finally met a man she wanted to marry. Now, at 38, she had given birth to their first child.
But Ostrinsky also had some bad news to worry about. Born 6 1/2 weeks premature, Benjamin now appeared to have blood leaking into his brain. She was trying not to dwell on the implications.
"My emotions have been running the gamut," she said. "It's been a real roller-coaster ride."
© 2002 The Washington Post Company |
