September 16, 2005
United States Premature Birth Rate Hits Record High

Bad news on the baby front.

WHITE PLAINS, N.Y., SEPT. 8, 2005 – Nearly a half million American babies were born prematurely in a single year, according to a government report issued today, putting them at increased risk for death and disability.

Some 12.3 percent of all babies – 499,008 infants -- were born prematurely (less than 37 weeks gestation) in 2003, according to the report released by the National Center for Health Statistics (NCHS). That's up from 12.1 percent (or about 480,000 babies) in 2002 – and an increase of more than 30 percent since the government began tracking premature births in 1981. The prematurity rate was 9.4 in 1981; it has increased every year since then except for slight dips in 1992 and 2000.

"Prematurity is the number one killer of newborns. We see from these latest statistics that the prematurity crisis in this country continues to intensify, and the aftermath of Hurricane Katrina will only make it worse, " said Dr. Jennifer L. Howse, president of the March of Dimes. "Babies are dying and those who survive are too often left with devastating consequences – such as cerebral palsy, mental retardation, learning problems and blindness."

Does anyone know the cause of this trend? More drug and alcohol abuse by moms? Could premies that were previously classified as stillborn be getting high tech medical treatments that cause more of them to be classified as live births?

A recent BBC report entitled "Many couples unfit for pregnancy" reports a lot of British women are irresponsible about drug and alcohol use while trying to conceive.

A poll of 2,000 women in the UK by Pregnancy & Birth magazine found two-thirds drink alcohol and four in 10 smoke while trying for a baby.

Only 44% of women hoping to conceive said they tried to eat a healthy diet.

...

A third of the women and their male partners trying to conceive were overweight, according to the responses.

Three out of 10 couples trying to conceive reported taking recreational drugs.

Damage from drug and alcohol abuse does not stop at the moment of birth. In Astoria Oregon half of all child welfare office workload is due to methamphetamine abuse.

“Meth is absolutely the worst drug in terms of child safety,” said Jay Wurscher, DHS Alcohol and Drug Services supervisor. “Children are put in dangerous, neglectful, abusive situations.”

About 75 percent of the 250 cases handled by the local Child Welfare office are drug- or alcohol-related, and of those, almost three-quarters involve meth, according to caseworker Chris Wilbur. “I joined the department in July 2001. It was a major problem then, and it has gotten steadily worse.”

Meth abuse has risen greatly in recent years. Could it be responsible for most of the increase in premies?

A recent study done with alcohol exposure to rhesus macaque monkeys used positron emission tomography (PET scans) on the brains of offspring to examine the effects of alcohol on fetal brain development.

Writing in the current issue (Sept. 15, 2005) of the journal Alcoholism: Clinical and Experimental Research, a team of researchers led by Mary L. Schneider, a University of Wisconsin-Madison professor of occupational therapy and psychology, reports that when a monkey exposes her fetus to alcohol by drinking, the dopamine system of her offspring is altered. Effects on that key neural system, according to the study's results, can manifest themselves up to five years after birth, when the monkeys are fully grown.

The influence of alcohol on the dopamine system, depending on the timing of exposure during gestation, varies, says Schneider, but illustrates yet another biological consequence of drinking while pregnant.

"It appears that there is no safe time to drink," says the Wisconsin researcher. "And because our study looked at the effects of lower doses of alcohol than most previous studies, the results suggest there is no safe amount of alcohol that can be consumed during pregnancy. Even moderate drinking can have effects that persist to adulthood."

Depending on what part of pregnancy the monkeys were exposed, alcohol made the monkeys either stimulation junkies or too easily distracted and overwhelmed by stimulation.

For two groups of monkeys, those exposed during early gestation, when dopamine neurons are first forming in the brain, and those exposed continuously throughout pregnancy, the dopamine system appears to be blunted, Schneider says. "If the dopamine system is blunted, you might not get the usual flushes of dopamine in response toe environmental events, and you may seek alcohol or drugs" as a substitute for the stimulation dopamine normally provides.

For the monkeys exposed to alcohol during middle-to-late gestation, the effect was the opposite: "Animals exposed later had supersensitive (dopamine) receptors. If you have supersensitive receptors, you're more susceptible to sensory overload and environmental stimuli can become overwhelming."

The new results add to a long list of alcohol's negative effects on the developing fetus. In the last 30 years, scientists have come to understand that exposing the fetus to alcohol, the drug most widely abused by pregnant women, leads to a host of health and development issues, including low birth weight, facial deformities and mental retardation. The availability of powerful imaging techniques such as PET, which can illustrate the brain at work, are helping scientists make even finer distinctions, linking damage to the developing brain to behavioral problems and learning disabilities later in life.

Why should someone have to grow up with the result of such exposure? Why should women be allowed to get away with abusing their bodies with drugs and alcohol while pregnant?

Also see my previous posts "Low Birth Weight Baby Development Problems Raise Ethical Question" and "Should Pregnant Drug Abusers Be Institutionalized?".

Share |      Randall Parker, 2005 September 16 03:37 PM  Bioethics Debate


Comments
please said at September 16, 2005 4:16 PM:

Three out of 10 couples trying to conceive reported taking recreational drugs? Um, there's clearly something wrong here. Isn't the most commonly used recreational drug (not including alcohol and tobacco) marijuana? -- I think the number of users of THAT isn't even 2 in 10.

Marvin said at September 16, 2005 5:34 PM:

What you are seeing is dysgenics at work. Higher intelligence couples are too busy working, consuming, investing, and achieving to have children. Lower intelligence couples, mostly unmarried, are having most of the children. The young women are not taking care of themselves, and are not getting adequate prenatal care. I used to deliver their babies, before I entered a more rational profession, so I know the large proportion of them who show up in labor without any prenatal visits at all. They seem not to care what they bring into the world. As if they do not expect to be responsible somehow. If you look at it that way, immigrants who bring more traditional values of maternal responsibility and a greater measure of chemical abstinence, will introduce a more eugenic influence, compared to the indigenous underclass that is currently supplying much of the next generation.

Nancy Lebovitz said at September 16, 2005 6:25 PM:

On the other hand, I think this is the first generation or so when any substantial fraction of society thought that women shouldn't drink at all during pregnancy. Shouldn't there also be some young people who are saner than average, and more coming along?

Does anyone know of studies of teetotalling cultures (Jehovah's Witnesses, Mormons(?), Moslems) to see whether there are average good effects?

palecur said at September 16, 2005 6:38 PM:

As you've commented on before, women from affluent societies are having children later and later in life, often with the help of various biotechnologies. Doesn't this also place them at more elevated risk of premature birth?

Randall Parker said at September 16, 2005 6:50 PM:

palecur,

Good thought. Yes, that'd cause a boost. I wonder how the premature birth rate looks now and in the past as a function of age.

Bob Badour said at September 16, 2005 7:03 PM:

Randall,

It would seem to me the most likely explanation is hospitals are attempting more live births of at risk babies because they feel they have the technology to do so.

Dave Schuler said at September 17, 2005 11:16 AM:
Does anyone know the cause of this trend? More drug and alcohol abuse by moms? Could premies that were previously classified as stillborn be getting high tech medical treatments that cause more of them to be classified as live births?
These are all certainly at work as well as the notion that we're breeding for it suggested above. Let me offer another: in vitro, hormonal treatments (especially on older first-time mothers), and artificial insemination may be resulting in women carrying multiples. Such multiples rarely come to term—they're almost always premature.
AA2 said at September 17, 2005 1:19 PM:

I've seen a study that looked at the affects of different severities of drug laws. And they found in jurisdictions or nations with the toughest laws and harshest penalties an interesting phenomenon happened. Only the absolutely most addictive and damaging drugs tended to remain and spread. I think we see this happening in America, as first we saw cocaine, then crack cocaine, and now meth which seems by far worse.

Whereas we see nations like Canada and Norway where drugs are illegal but penalties are very light compared to America, or with drugs like Marijuana no real punishments, the dangerous and highly addictive drugs aren't spreading. There is no Meth problem in Canada and no crack cocaine that I have ever heard of.

Of course the spread of meth is only one factor I would think in these premature babies. Other big ones like the disgenics and especially increasing technology to save babies are there.

toot said at September 17, 2005 1:30 PM:

It might be enlightening to compare the total fraction of uninterrupted pregnancies that end in either premature births or still births. That would give an indication of whether the greater number of premature births arises simply because the US medical community is attempting to save babies that other communities regard as futile cases, as has been suggested above. If the US fraction exceeds that of other nations, it would suggest that some factor is affecting women and their pregnancies. If the calculation could be carried out by age bracket, it would also take care of the possibility that late pregnancies contribute to the anomaly.

ziel said at September 17, 2005 3:39 PM:

Why should women be allowed to get away with abusing their bodies with drugs and alcohol while pregnant?
Randall, what do you suggest to stop it? I think the effects of moderate alcohol consumption during pregnancy are probably too subtle (and too probabalistically defined) for people to see and therefore believe. Complete abstinence, which is obviously preferred, appears to be confined (from my observation) to the highly intelligent or highly neurotic. Hopefully, more studies will provide more clearly understandable results that will convince the average pregnant woman to avoid booze altogether.

Bob Badour said at September 17, 2005 4:19 PM:

AA2,

Apparently you missed the news a few years ago about the gang war between Satan's Choice (now Hell's Angels) and The Rock Machine (um, I wonder where they got that name?) primarily over control of the meth market in Canada. Not many drive-by shootings -- they tended to go more for bombs and really big explosions.

x said at September 18, 2005 8:40 AM:

“The lowest birth weights were found among babies born to unskilled and unemployed women even after adjustment for smoking habits, prepregnancy height and weight and a number of other potential confounders. . . .The study shows that socioeconomic status is especially a risk factor for low birth weight.”
Olsen J, Frische G, “Low birth weight, stillbirth and congenital malformations. Social differences.” Ugeskr Laeger, Sep 19 l994; 156(38):5519-5523.

“White infants were heavier and born later than black infants. The white women in this sample smoked more cigarettes, moved more frequently, and had worse psychosocial scores. The black women had lower incomes, were less likely to be married and had more hypertension, anemia and diabetes.”
Goldenberg RL, Cliver SP, Mulvihill FX, Hickey CA, Hoffman HJ, Klerman LV, Johnson MJ, “Medical, psychosocial, and behavioral risk factors do not explain the increased risk for low birth weight among black women,” American Journal of Obstetrics and Gynecology, Nov l996;175(5):1317-1324.

“. . . the rate of LBW [low birth weight] is twice as high and the rate of VLBW [very low birth weight] is three times as high for black infants compared to white infants.”
Luke B, Williams C, Minogue J, Keith L, “The changing pattern of infant mortality in the US: the role of prenatal factors and their obstetrical implications,” International Journal of Gynaecology and Obstetrics, Mar l993; 40(3):199-212.

“The deficits of weight at birth in children born to mothers who smoked during pregnancy are overcome by 6 months of age. These deficits are probably not permanent when smoking habit during pregnancy is not associated with other unfavourable variables (such as lower socioeconomic class).”
Conter V, Cortinovis I, Rogari P, Riva L, “Weight growth in infants born to mothers who smoked during pregnancy,” British Medical Journal, Mar 25 l995; 310(6982):768-771.

“Lower socioeconomic status (SES) is probably the most powerful single contributor to premature morbidity and mortality, not only in the United States but worldwide.”
Redford B. Williams, MD, “Lower Socioeconomic Status and Increased Mortality,” Editorial, Journal of the American Medical Association, June 3 l998; 279(21): 1745-6.

Marvin said at September 18, 2005 9:13 AM:

I am trying out a new name, x. I think it has a ring to it.

African-Americans are 1.8 times more likely to deliver premature infants and 2.3 times more likely to
deliver very premature infants than Caucasians, according to the NIH. As I mentioned above, I was there on the front lines in the labor and delivery rooms. I could watch it happen with my own eyes, and observe the reasons it was happening.

There are many reasons for the trend, but one explanation overrides them all by a large margin. The transfer of the bulk of the burden of indigenous births from married women of all socioeconomic classes, to unmarried women of lower socioeconomic classes. A lot of these women have the "don't give a damn!" philosophy of life. Whether that is due to low intelligence, cultural factors, deprived and abusive upbringing, or all of those and more, would be a better topic of debate than the reason for the trend, which is within the grasp of anyone with internet access. Debating the reason for the trend without going and looking is like debating how many angels can fit on a pinhead. I thought they beat that type of thinking out of students in school, but apparently not anymore.

RB said at September 20, 2005 10:04 PM:

I completely agree with Marvin. Dysgenics and the general tendency for rapid low IQ proliferation is key here. Those people won't do what's necessary for a healthly birth - and maybe in some ways a good thing too, being fewer future criminals and state aid-sucklers surviving. Darwin at last!

Marvin said at September 21, 2005 4:52 PM:

There is nothing about this trend toward careless motherhood that is good. This will not bring fewer future criminals, in fact probably more. Neonatologists are keeping more and more of these essentially non-viable fetuses alive, so that RB can pay for their continued upkeep for many decades. Unmarried underclass mothers are the bottom of the barrel, but they are bearing more and more of the burden of populating the western world. This is dysgenic, true, and also suicidal.

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