a294  2148  29 Aug 87
BC-APN--Preemie's Chances, Adv13,0838
$adv 13
AGENCIES AND RADIO OUT
For release Sun., Sept. 13
From AP Newsfeatures
With BC-APN--Born Too Soon
    
By PAUL RAEBURN
AP Science Editor
    NEW YORK (AP) - With recent advances in treatment, more than half of
the babies born weighing less than 2 pounds will survive and lead
normal lives, pediatricians say. But little progress has been made at
reducing the incidence of premature births.
    In 1984, 6.7 percent of all babies born in the United States were
low birthweight babies, weighing less than 5 pounds, 8 ounces,
according to the Children's Defense Fund in Washington. Twelve out of
1,000 were very low birthweight babies, born at less than 3 pounds.
    While survival rates for such infants have climbed dramatically
during the last few decades, the incidence of prematurity has
scarcely changed. In 1950, 7.5 percent of all babies were low
birthweight. And the incidence of low and very low birthweight
children among blacks is more than double the rate among whites in
the United States.
    ''Being born early is a relatively common problem in the United
States,'' says Dr. George Little, a neonatologist, a specialist in
the care of newborn infants, at Dartmouth University. ''It's one of
our leading health problems.''
    Blindness is one of the serious consequences of prematurity. Other
long-term complications of extreme prematurity include cerebral
palsy, mental retardation and chronic lung disease.
    The likelihood of serious problems climbs sharply the more premature
an infant is.
    ''If you're born a month early, your problems are usually not too
great,'' Little says. ''If you're born two months early, your
problems are greater. If you're born three months early, you're
getting to the area where survival is not that great.
    ''The way I like to explain this to parents and medical students is
if you're born a month early, you're premature. But when you get to
two or three months early, you're not only premature, you're
immature.''
    At that age, many of the body's systems are not suitably developed
for life outside the womb.
    Such children face a variety of short-term problems, including
infections and the inability to regulate their own temperatures. They
must be administered oxygen to compensate for the immaturity of the
lungs.
    It is the oxygen that, for unknown reasons, can cause the
retrolental fibroplasia that results in blindness in some children.
    With careful control of the oxygen supply, the incidence of
blindness has dropped, says Dr. Ronald Poland, chairman of the
Committee on Fetus and Newborn of the American Academy of Pediatrics.
    ''In the mid-1950s, retrolental fibroplasia was the cause of most of
the blindness in schools for the blind,'' Poland says. ''Now it's a
relatively rare event. Still, not rare enough.''
    Children with chronic lung disease may need oxygen for as long as a
year. In rare cases, the lung disease can last for a lifetime or can
be fatal.
    Cerebral palsy is a movement disorder that can range from mild
incoordination to severe spasticity and inability to walk. Mental
retardation is less common, Poland says.
    Premature babies often require weeks or months of intensive care. As
a rule of thumb, doctors say that a baby born three months premature,
will require about three months in the hospital, a baby two months
premature will be in the hospital two months.
    The cost of such care can be enormous. A study estimated that in
1978 the average cost for hospital care for a baby weighing less than
2 pounds, 3 ounces was $40,000 in 1978. Dr. Ernest Kraybill of the
University of North Carolina in Chapel Hill estimates the average
cost might be closer to $100,000 now. He says that bills of $100,000
or even $200,000 are not unusual.
    But Kraybill says neonatal intensive care is cost-effective because
so many years of useful life are saved when it is successful,
Kraybill said.
    ''You've got a whole life in front of you,'' Little says. ''Let's
remember that most kids who come out of neonatal intensive care do
very well. They're highly productive, tax-paying members of
society.''
    Nevertheless, he believes that much more should be done to prevent
prematurity. The problem is that doctors do not know precisely what
causes it.
    They do know, however, that it is more common in poorer families,
and in those without access to a doctor's care.
    ''That's not to say that prematurity does not occur in
well-educated, stable families. It does. But the risk is much lower
there,'' he says.
    The most important prescription for prevention, therefore, would be
to make prenatal care available to mothers who cannot now afford it,
he say.
    Poland agrees, and adds:
    ''The other thing that should be mentioned over and over again is
all babies should be planned and wanted. If we had a society that
stuck to that principle, we'd probably have fewer babies and fewer
babies with problems.''
    END ADV
 
 
AP-NY-08-30-87 0033EDT
***************