Panel discusses prematurity
Researcher for Vida Health Communications Lisa McElaney spoke about infant brain development.
On Nov. 17, 57 countries worldwide participated in World Prematurity Day. March of Dimes, a nonprofit organization that works to improve the health of babies by preventing premature birth, birth defects and infant mortality, has devoted the month of November to educating expecting parents and health care workers about premature birth. State Director of Programs Services at March of Dimes Dr. Alex Travis, social epidemiologist and Heller School for Social Policy and Management lecturer Lindsay Rosenfeld and public health researcher for Vida Health Communications Lisa McElaney spoke at a panel last Tuesday at Brandeis about “Perspectives on Prematurity.”
Travis, the first panelist, said that premature birth rates experienced a rising trend until 2006, when they reached a peak. In 2006, 12.8 percent of all births in the U.S. were premature. She also said that due to greater awareness and the efforts of March of Dimes and other organizations, the prematurity rate has since dropped to 11.4 percent. Travis went on to discuss the major concerns associated with premature birth. She explained that premature birth can often have lifelong effects on children and can cause cognitive disabilities, respiratory issues and problems with eyesight. She also emphasized the tremendous amount of money spent on treating the effects of premature birth—approximately $26.2 billion annually.
Travis explained that many of the known causes of preterm birth are actually preventable. Such causes include elective early caesarean sections, smoking and alcohol consumption. She said that March of Dimes aims to eliminate such causes by discouraging early induced labor and caesarean sections, recommending progesterone therapy, increasing access to maternity care and educating mothers about links between smoking and alcohol and premature birth.
Travis said that March of Dimes currently has over 200 associated researchers who are looking into other potential causes of preterm birth. The organization plans to invest $75 million more in premature birth research in the upcoming years. She described March of Dimes’ focus on synergy, or bringing together scientists from all different fields to cooperate on research and education projects. March of Dimes currently has two transdisciplinary research centers—in California and Ohio—and plans to open two more facilities at the University of Washington and the University of Pennsylvania this coming year.
Rosenfeld was next to take the podium. She approached the topic of prematurity from a more personal angle, describing her experience of giving birth to premature twins. She described this moment as “when my work became my life.”
Rosenfeld recalled the day when she was at her OB-GYN appointment for a routine pregnancy ultrasound and her doctor told her she needed to go to the hospital immediately. When she arrived at the hospital, she said, she discovered that she was in preterm labor and spent two and a half weeks on bed rest. She gave birth to her twins at only 28 weeks and five days into her pregnancy, while they were still in the “micro-premature” stage of fetal development. Rosenfeld explained that both twins were placed in the Neonatal Intensive Care Unit at Children’s Hospital of Boston to be monitored for several weeks. Rosenfeld was informed that one of the twins suffered from a diaphragmatic hernia, which is when the diaphragm muscle fails to close completely and some of the abdominal organs move into the chest cavity. She described the many struggles she and her husband endured during and after the long period of time that their twins spent in the NICU.
McElaney, the third panelist, spoke about the major impact of the NICU environment on early-stage brain development in infants. She showed part of a documentary film that illustrated some of the recent discoveries about the adverse impact of the NICU on neonatal brain growth and development.
The film first stressed the importance of the third trimester of pregnancy, explaining that many important aspects of the brain’s circuitry are formed during this period. It explained that the third trimester is a stage very important for the development of the myelin sheath, which is a casing comprised of lipids and proteins that help to protect and insulate neurons. The movie showed images depicting the major morphological differences between the cortex—the part of the brain responsible for executive functions—of infants at the ages of 28, 32 and 40 weeks. One of the researchers in the film pointed out a correlation between infants who spend a longer time the womb and increased gyrification, or folding, of the cortex region in the brain. The researcher explained that the increased gyrification is often associated with an increased intelligence. Gyrification does continue, however, even after an organism is born.
The documentary then explained that, unlike healthy babies, many preterm babies spend their critical periods of neural development outside the womb in the NICU. In the film, several researchers emphasized the negative impact that the stressful environment of the NICU can have on a child’s emotional, cognitive, social and communicative brain. The documentary mentioned that elements of the NICU such as loud noises, extensive machinery, artificial light and lack of skin-to-skin contact might affect many aspects of an infant’s development. “The disorder and the impact of it is part of who the child then is for the rest of their lives,” said one of the researchers in the film.