The article below appeared in the Boston Globe this morning.
Breastfeeding is not one of the measure they looked at, in fact the
word does not appear in the article. Perhaps that is because the study
population was in Norway with high breastfeeding rates. Perhaps one of
the reasons outcomes for premature babies in the US are worse that in
Norway is that we do not have good bf rates. This would have to be
studied, of course, but it does give one pause, and the need for
further research on effects of breastfeeding and use of banked milk
for improving long term outcomes for premature babies.
The article indicates that premature babies are less fertile as
adults. I found that finding interesting, but somehow not surprising.
Does anyone know when the reproductive system develops in utero?
http://www.boston.com/news/nation/articles/2008/03/26/premature_babies_facing_risks_well_into_adulthood?mode=PF
Premature babies facing risks well into adulthood
Long-range study finds higher rates of childhood death
By Carla K. Johnson, Associated Press | March 26, 2008
LOS ANGELES - Infants born prematurely are much more likely to die
during childhood and, if they survive, are much less likely to have
children of their own in adulthood, according to the largest study of
prematurity ever undertaken.
Researchers already knew that premature infants faced many
neurological and developmental problems, but the new findings,
released today, indicate that the spectrum of problems is even broader
than suspected and persist throughout the child's lifetime.
The study, conducted using Norwegian birth data, suggests that, as the
percentage of premature infants who make it through their first year
continues to grow because of advances in neonatology, the number of
troubled infants and adults will also rise.
"Are we improving their survival at the expense of significant
problems down the road?" asked the lead author, Dr. Geeta Swamy of
Duke University Medical Center.
Specialists said the situation is probably worse in the United States.
"Norway demonstrates better outcomes than the United States, which has
persistent, stark racial disparities" in care for the premature, wrote
Melissa M. Adams of RTI International in Atlanta and Dr. Wanda D.
Barfield of the Centers for Disease Control and Prevention in an
editorial accompanying the report in the Journal of the American
Medical Association.
One in eight US infants is born prematurely, a total of more than half
a million per year, despite the best efforts of physicians to bring
more pregnancies to full term - defined as 38 weeks or longer.
Researchers are not sure why the US rate is so high, but contributing
factors include the growing incidence of assisted reproduction, which
often produces twins or triplets, which are more likely to be born
prematurely.
There is also a rising incidence of deliberately induced premature
deliveries and caesarean sections - many because of distress to the
mother or infant, but some for the convenience of doctor or mother.
The consequences can be devastating, particularly for very early
births. They include learning disabilities, neurological problems,
lung diseases, and cerebral palsy.
Using Norway's extensive registry of births and medical care, Swamy
and her colleagues studied all 1,167,506 singleton births in that
country between 1967 and 1988, following the children through 2002.
They also looked at educational achievement and reproduction in the
group born between 1967 and 1976.
A total of 5.2 percent of the births were premature, less than half
the percentage in the United States.
For boys born the most prematurely, between 22 and 27 weeks, their
risk of death was 5.3 times higher than normal between the ages of 1
and 6 and seven times above normal between 7 and 13. For boys born
between 28 and 32 weeks, the risk of death was 2.5 times higher than
normal in early childhood and 2.3 times above normal in late childhood.
The most premature girls had 9.7 times the normal risk of death
between ages 1 and 6, but no increased risk between ages 7 and 13.
Girls born between 28 and 32 weeks did not have a significantly
increased risk of death.
The investigators are not sure what accounts for the increased risk,
but some of it is related to cancer and congenital abnormalities,
Swamy said.
In adulthood, boys born the most prematurely were 76 percent less
likely to reproduce, with only about one in seven having children.
Women were 67 percent less likely to reproduce, with one in four
having children.
Preterm women, but not preterm men, were at increased risk of having
premature offspring.
Those who were born prematurely were also significantly less likely to
finish high school or to complete college studies.
To see the research article, go to jama.ama-assn.org.
------------------------------------------
Naomi Bar-Yam Ph.D.
Executive Director
Mothers' Milk Bank of New England
[log in to unmask]
617-964-6676
www.milkbankne.org
------------------------------------------
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