Preterm labor is a common condition that affects about 1 in 10 babies and can lead to lifelong health consequences. Researchers at the University of Nevada, Reno have been looking for a solution and are a step closer to finding one. Reno Public Radio’s Noah Glick reports.
When it comes to premature births, Nevada still lags slightly behind the rest of the country. That’s a problem because babies born before 40 weeks are more at risk of developing serious, chronic conditions, such as blindness, intellectual disability and respiratory problems.
So, what can we do about it?
“In the context of prematurity in America, there’s no drug, there’s no treatment. Nothing works," says Dr. Iain Buxton, a research scientist at the University of Nevada, Reno.
His lab is focused on preterm labor: determining its cause and finding a way to prevent it. To do that, he and his team are examining uterine tissue to better understand how the muscle of the uterus works and what actually triggers labor.
“We’re studying the contractile relaxation pathway," Buxton explains, "which we discovered is completely different than other smooth muscles in the body. That was the first breakthrough we made some years ago.”
Buxton then scoured medical journals for drug treatments that target this specific pathway. And, after finding one, he began testing it.
“We are now analyzing that drug in our pathway, and we had some really encouraging evidence that we might be on the right track," Buxton says. "Imagine, could there be a more difficult circumstance for drug testing than giving a drug to a pregnant woman carrying a fetus?”
Despite this challenge, Buxton says that if possible, drug treatment could provide a huge impact on the lifetime cost of healthcare, beginning right at birth:
“The neonatal isolate, that plasticized environment that that premature infant sits in, constitutes the most expensive bed in the hospital.”
A big burden is also placed on taxpayers.
“We all bear the cost," says John Packham. He’s the Director of Health Policy at the University of Nevada School of Medicine. "We pay taxes that support Medicaid and our state’s children’s health insurance program. And to the extent that we reduce the incidents of low birth weight babies and preterm labor, we’re reducing the cost of those programs.”
Packham wants to see greater thinking outside of traditional medical care in order to create lasting change:
“It requires public health measures. It also requires greater attention, quite frankly, to family planning services that are really under attack. It’s important to remember that access to family planning services is one part of the puzzle in reducing costs.”
Another way to reduce incidents of early labor—and the costs associated with them—is to eliminate elective deliveries, or voluntary early births. Bre Taylor is the Director of Maternal Child Services at St. Mary’s Hospital in Reno, and she says they’re not medically necessary.
“It’s a personal choice. They want to deliver earlier," Taylor says. "Maybe they truly don’t understand the implications of delivering the baby before the baby’s actually due.”
Stopping elective deliveries is also a major goal of the March of Dimes, which recently released its annual Premature Birth Report Card. While Nevada scored a C on the report, Reno earned a B, beating out the national average.
Michelle Gorelow is with the Nevada branch of the March of Dimes. She says that having access to proper prenatal care can help women deliver on time, but there is one major obstacle in their way.
“It’s really a transportation issue," according to Gorelow. "There’s definitely a disparity between rural and urban areas, where the rural [people] don’t have any doctors whatsoever and so those women are traveling several hours to get to a doctor. Even though we have in Las Vegas more doctors, there’s still the transportation issue of getting to that doctor: going on the bus, especially if you have small children, if it’s really hot outside, the bus is late. Then all of a sudden they’ve missed the appointment, and so it can be very challenging.”
To help, the March of Dimes has been implementing support programs to connect pregnant women who are due around the same time.
“That way they can help with each other. They can help with transportation," Gorelow says, "help encourage them to eat healthy, to make healthy lifestyle choices, and we’re finding with those programs that the women are 30-40 percent less likely to deliver a preterm birth.”
Even with all these challenges, Gorelow says Nevada is making progress.
“I absolutely see hope. Nevada used to be an F, and then we became the D, and now we’re a C.”
Plus, with Reno getting that B grade already, Gorelow says it’s only a matter of time before Nevada gets an A.