Thursday, January 14, 2010

Preventing Late Preterm Births ~ Since Every Week Counts

I recently attended a webinar in the comforts of my office, complete with Power Point presentation and bibliography downloadable.

Presented by NPIC/QAS Educational Services, this webinar (complete with CEUs) was titled: Preventing Late Preterm Birth: Since Every Week Counts. The presenter was Karla Damus PhD, MSPH, RN, FAAN Dr. Damus is an Associate Clinical Professor and Dir. of the Div. of Public Health and Community Programs in the Dept. of Ob/Gyn and Women's Health at the Albert Einstein College of Medicine. She is a consultant to the Office of the Medical Director at the National Office of the March of Dimes where she designed and is Program Director of the national model initiative to reduce preterm births in Kentucky - Healthy Babies are Worth the Wait. Dr. Damus is a Fellow of the American Academy of Nursing, a Fellow of the NY Academy of Medicine, and a member of: the Select Expert Panel on Preconception Health, and the Nurse Advisory Council for the National March of Dimes. She is also a consultant to the Ob/Gyn Devices Panel of the Medical Devices Advisory Committee Food and Drug Administration. Dr. Damus is a perinatal epidemiologist and nurse, having received her PhD in epidemiology from the University of California and two masters degrees from UCLA in Nursing and Public Health.

Preterm birth is currently the #1 obstetric challenge in the US and is the major cause of all infant mortality in the US. Preterm birth is a leading problem in pediatrics, responsible for nearly all neonatal morbidity, half of all neurodevelopmental conditions, 20% of mental retardation, 33% of vision impairments and 50% of cerebral palsy. Preterm birth has also been associated with higher rates of chronic illness, such as heart disease and diabetes, in adults.

Over the last 20 years, there has been a 30% increase in preterm births in the US, with 37% of all preterm births being late preterm births or those babies born between 34 and 36 weeks. Dr. Damus defined preterm as being between 20 weeks and before 37 completed weeks; late preterm as 34 weeks 0/7 days to 36 weeks 6/7 days (239-259 days); term as live birth between 37 weeks 0/7days to 41 weeks 6/7 days (260-294 days); and postterm as live birth from 42 weeks 0/7 days (295+ days). Non-Hispanic Black women tend to have significantly more late preterm births than Hispanic or Non-Hispanic White women. Similarly, women 24 years old and younger plus women 35 and older had more late preterm births than women 24 – 35. Geographic difference were significant was well and you can check your states report card at

Dr. Damus cited the changing culture of childbearing as contributing to the rising late preterm rates including more high risk pregnancies, public preferences for elective induction and CDMR, clinical management with more interventions and defensive medicine due to today’s litigious society.

She also discussed the progression of fetal brain development, noting that the lower functions of the brain mature first, the cortex is the last to develop and the brain at 35 weeks gestation weighs only 2/3 what it will weigh at term. The volume of white matter increases 5 fold from 35 -41 weeks and the brain basically organizes during this time period – developing synapse, neurotransmitters and more.

This great webinar is available on the NPIC/QAS Educational Services website for $25. Other webinars are also available in their archive section. Truly a great opportunity!

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