Junkfood Science: Where are the headlines?

April 13, 2007

Where are the headlines?

MIA: News in every (or any) media outlet sharing the latest CDC report on our nation’s babies. Might it be because the concerns it points to are not the politically correct ones?

The U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics just released its 2005 report on births and maternity and infant health data for the United States. The QuickStats from 1990 to 2005 published in today’s issue of the CDC’s Morbidity and Mortality Weekly Report was worthy of headlines all by itself: The percentage of babies born prematurely has increased 20-29% over the past 15 years, while those born at term have declined 15%.

A closer look at the data shows that these worrisome statistics are not due to increases in teen pregnancies, a recognized risk factor for premature deliveries. In fact, there’s good news there. Teen birth rates have dropped 35% to their “lowest rate ever recorded in the 65 years for which a consistent series of rates is available.”

Going back further in time finds an increase in the rate of premature births of 30% since 1981. Babies 34 to 36 weeks gestation now make up 9.1 percent of births and those even more premature make up 2.03 percent.

More than half a million babies are born prematurely each year in the United States. The data shows that it’s not just due to an increase in multiple births, but prematurity has also increased among singleton deliveries. (About half of all twins and 93% of triplets on up are born prematurely, and multiple births are higher among mothers who’ve had fertility treatments.) And, while Blacks continue to have the highest rates of preemies (18.4%), increases are seen among all racial/ethnic groups.

The rate of babies with low birth weights is also increasing — more than 20% just since the mid-1980s and is now at the highest level ever reported since 1968! Babies of low birthweight now account for 8.2% of all births.

This isn’t just an American concern. A week ago, Staff Nurse reported that Britain is facing a growing epidemic of tiny babies, with the highest levels since 1989. “Britain has the highest rate of underweight babies in western Europe outside Greece,” according to a Fabian Society report.

If the welfare of children and improving their chances for healthy futures were really our concern, the media wouldn’t be filled with stories fretting over baby fat, but would be showing some concern for the growing numbers of babies without enough.

Many typically think of undernourished mothers in developing countries when they think of premature deliveries, not something this common in our countries. Yet, today’s CDC report shows it is worthy of our attention.

Prematurity is the leading cause of death in the first month of life, accounting for two-thirds of babies in the United States who die. Despite increases in the incidences of prematurity, bear in mind that overall infant mortality on our country has nearly halved over the past 15 years. Advancements in neonatal intensive care have improved their chances for survival. Still, their morbidity is higher. These small babies are much more vulnerable to long-term complications such as cerebral palsy, mental retardation, chronic lung disease, vision and hearing loss, learning difficulties, and poor growth and development, according to the July 2006 Institutes of Medicine report “Preterm Birth: Causes Consequences and Prevention.”

Prematurity is a major contributor to life-long disability, according to the March of Dimes. Higher risks seen among preterm and underweight babies for earlier onset of chronic diseases later in life such as heart disease, hypertension and diabetes is also being increasingly recognized.

While prematurity takes a devastating emotional toll on the families, it touches everyone. According to the IOM report, medical care for each of these babies average $33,200, plus $1,200 in early intervention care and $2,200 in special education needs. An earlier report by the March of Dimes found hospital bills alone for premature babies were $18.1 billion in 2003.

Several other findings in today’s CDC report reflect popular trends that may indicate double-edged swords.

Nearly one-third of all babies born today are by cesarean section, another record high for the country, according to the CDC. A recent CDC examination found that premature inductions for delivery had doubled just from 1989 to 1998, and were higher among white women who were college educated and who’d had the most intensive prenatal care. These researchers found that nearly 60% of the inductions were among babies as much as 4-5 weeks early and their neonatal mortality rates were 20% higher than term babies.

Today’s report also shows that women are having babies later in life. As has been well-established, preterm deliveries increase among older women. Mothers in their late 30s are now at the highest levels since 1965 and women aged 45-49 having babies is at the highest rate since 1970. While the press glorifies perpetual youth and highlights Hollywood stars having babies at increasingly older ages, the inherent risks are rarely mentioned.

Nearly half of premature births have no known cause, according to March of Dimes research. And medical research has yet to fully understand the causes for premature births and the full variety of socioeconomic and biological factors that increase the risks. But according to a report in the journal Pediatrics, of the American Academy of Pediatrics, among the things known to play a role in prematurity include those we’ve looked at, such as maternal age, multiple gestation, low weight in the mother and low weight gain during pregnancy. As noted in an earlier post, American medical professionals learned in the 1950s that recommendations to restrict maternal weight gain during pregnancy resulted in smaller babies with more health complications and poorer chances for survival.

The recent surge in underweight babies being born in British Columbia has health officials there worried, too. They have recently been telling mothers that it’s not what they eat, but how much that’s important to having a healthy baby. A recent survey found that only three percent of pregnant women knew the importance of eating enough. Gaining sufficient weigh during pregnancy is important as it affects how much her baby weighs at birth, said Interior Health officers. As CBC News reported:

“Low birth-weight babies may be associated with ... heart problems, lung problems, digestive problems, sometimes even into learning disabilities later on in life,” said Paul Hasselback, senior medical health officer with Interior Health....Just as disturbing, said Shelly Inglis Allan, a low-birth-weight prevention officer in B.C.'s Interior, some women intentionally avoid gaining weight. “It often came back to societal pressures around being thin,” she said.

Gossip magazines perpetuate the image, criticizing celebrity Britney Spears for not shedding her baby weight. It's also been reported that actress Angelina Jolie, who is pregnant, "hates her swollen body."Expectant mother Kyla Grant said she tells her boyfriend she "feels fat.” ...

“The image in general is thin, thin, thin,” Lang said. “They don't want to lose their figure. They don't want to eat because they think they will get fat and big, and they won't be able to lose it.”

How much might popular obsessions with thinness and “healthy” eating, and even our government's role in heightening weight concerns and low-fat, calorie-controlled eating, be contributing to some of the unhealthful trends reported today here?

Other under recognized factors associated with premature and underweight babies include low social class, illness, drug or tobacco use, infections, lack of prenatal care, anemia and major stress. The EUROPOP study of 16,000 women in 17 European countries found a woman had double the risk for premature labor if she faced stressful situations such as low socioeconomic status, long working hours, strenuous or stressful work, long commutes to work or unemployment.

Stress may be a surprise but, according to the March of Dimes, “stress-related hormones may constrict blood flow to the placenta, so the baby may not receive the nutrients and oxygen it needs for optimal growth.” Studies also suggest that high stress levels contributes to pregnancy complications such as preeclampsia (a pregnancy-related disorder that includes high blood pressure and can result in poor fetal growth and other problems) and miscarriage. A recent study conducted in Brazil, published in the European Journal of Clinical Nutrition, followed 865 pregnant women, evaluating their levels of stress and distress several times throughout their pregnancies. Mothers’ distress was associated with a two-fold increase in low birth weight babies and nearly 2 1/2 times high risks for premature babies.

Why was there so little attention given to today’s CDC report? Are the media and government thinking of their possible roles in these trends? Another consideration is the undue stress being felt by pregnant women. Our culture’s heightened climate of fear brings a steady string of unfounded scares directed towards them. The media reports frights about trace exposures to chemicals and fears over the safety and wholesomeness of seafood, milk, meat, sugars, dietary fats, processed foods, fruits, poultry, vegetables, etc. Turning the panic dial down and reporting credible, evidence-based information is an important role for media while medical research turns its focus on how to help all babies be born healthy.

© 2007 Sandy Szwarc

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