Prematurity to early infant care, what you need to know

Every mother hopes to have a complication-free pregnancy and to give birth to a healthy baby after a full 40 weeks. Unfortunately, premature births –that is, any births before 37 completed weeks of gestation– are too common within the African-American community.

While prematurity is a problem for American women of all ethnicities, African Americans have the highest chance of delivering a baby prematurely. About 100,000 Black babies are born too early each year, representing nearly 20 percent of all preterm births in the U.S.

Why are African-American babies more likely to be premature? Unfortunately, science has yet to explain all of the reasons for preterm labor, or why prematurity is more prevalent among African Americans. Even if a woman takes every possible precaution, she can still have a premature baby.

There are, however, some known risk factors for premature birth, some of which are common among African-American women.

High blood pressure and diabetes –both risk factors for prematurity– are significant health problems among African-American women. These are often brought on by being overweight and having high cholesterol levels.

In addition, studies show that smoking during pregnancy often leads to premature labor. Approximately 25 percent of Black women in the U.S. do not receive early prenatal care within the first trimester of pregnancy. This may contribute to increased prematurity rates among African-American women.

What challenges does a premature baby face? Being born early disrupts normal organ development. For example, the lungs of the premature baby are not as capable of absorbing oxygen and they collapse more because they do not have enough of a type of cell that makes important substances that allow for the lung to stay open.

This puts premature babies at increased risk for respiratory complications.

Preemies are also born without all the virus-fighting antibodies they need and get from their mother while in the womb. This means they have an immature immune system and are more prone to infections such as respiratory syncytial virus (RSV), a widespread seasonal virus that is very common during the fall and winter months.

Even babies born just a few weeks early are at increased risk for health problems.

In fact, the majority of preemies are born between 32 and 35 weeks gestation. Parents of larger premature babies need to remember that while their baby may look healthy, he or she might still face complications.

What is RSV and why are African-American infants at risk? RSV is a very common virus. It’s so common that virtually 100 percent of all children contract it by the age of 2. In most healthy children, the symptoms are similar to the common cold and parents may never know that their child has it.

But for preemies and babies with certain heart and lung conditions, RSV can lead to a very serious infection requiring medical attention. In fact, RSV infection is the leading cause of infant hospitalization in the U.S., representing 1 in 13 pediatrician’s visits and 1 in 38 trips to the emergency department.

According to some studies, infants from multicultural communities —particularly African-American babies— are at increased risk of developing severe RSV, resulting in hospitalization and even death.

In fact, one study of almost 20 years of data showed that twice as many Black infants die from RSV each year, compared to White children.

While we don’t know the exact reason for the increased risk of RSV among African-American babies, the fact that more premature babies are born in this community than any other may be a contributing factor.

Other known risk factors that may increase the chances of getting RSV include school aged siblings, maternal tobacco use, day care attendance, exposure to environmental smoke/air pollutants, and crowded living conditions.

How can parents protect their babies from RSV?

There is no treatment for RSV, so prevention is key. RSV is highly contagious, so washing hands and/or using a hand sanitizer gel, cleaning toys and bedding frequently and avoiding bringing your baby around people who are sick or in large crowds, where they may be exposed to the virus, can help.

Babies at high-risk for RSV infection may qualify for a preventive therapy. Parents should speak to their child’s health care provider about preventing RSV.