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Environmental chemicals contribute to rise in premature births

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DAYTON, Ohio _ We often hear about the dramatic increases in childhood obesity, asthma and health care costs, but rarely do we hear much about something that contributes to all three.

"Premature births are a silent epidemic," says Dr. Alan Greene, a Stanford University pediatrician. "One in eight babies in the United States is born prematurely, and it's a sign that something is going wrong."

The rate of premature births has increased by 31 percent since 1981, to 499,000 babies born more than three weeks early in 2003. That's almost 118,000 more than if the rate had held steady, each at an added medical cost of nearly $39,000 in just the first year.

The most popular explanations are the rising numbers of both older women having babies and fertility treatments, which increase the chances of multiple births. They both do add significantly to the preemie rate. But Greene adds a third reason, the widely overlooked increase of toxic chemicals in fetuses' blood.

The Environmental Working Group reported this summer that mothers ingest and pass to their unborn babies 217 chemicals known to harm fetal brains. The chemicals come from clothing, food packaging, flame retardants, pesticides, food additives and emissions from power plants and plastic production, among other prevalent sources.

"What's happening essentially is (fetuses) decide it's not safe in here anymore," Greene said. "That's why the baby's being born prematurely."

This isn't some new, far-fetched theory, Greene said. "The tiniest amount of pesticide increased the risk of prematurity by 90 percent," he said of a study four years ago at the University of North Carolina, analyzing 40,000 blood samples from pregnancies in the 1960s. "They went on to estimate that 15 percent of infant deaths in the '60s could be attributed to pesticide exposure before birth."

The direct medical costs in a pre-term baby's first year are $41,610, according to the March of Dimes, or 15 times the costs of a full-term baby. Preemies raise the average cost of every baby with employer-sponsored insurance by 2-1/2 times, from $2,830 to $7,139. But more than half of preemies aren't in employee health plans, usually without prenatal care, leaving taxpayers on the hook for most of their $11 billion cost per year.

Preemies are well-known to have higher rates of asthma, cerebral palsy, low IQ, learning and social difficulties, vision and hearing disorders, and infant death. They're less commonly associated with the childhood obesity rate, which is three times higher than in the '70s.

But as with the environmental connection, Greene said the data has been around to connect prematurity with obesity. Low birthweight has been associated with eventual obesity, and preemies are far more likely to be low in weight. People just haven't connected the dots.

"When (fetuses') nutrients are restricted, their metabolism forms in a way that they want to save everything they can," Greene said. Besides likely triggering premature births, pesticides and other chemicals tend to restrict the nutrients a fetus can ingest. So after developing bodies that cling desperately to every ounce in the womb, it's not surprising that these fetuses would grow up to be children who retain more weight than they need.

Childhood obesity then extends the added medical costs for preemies well beyond that first year. Obese kids are more likely to become obese adults with higher rates of diabetes, heart disease, asthma, arthritis and some cancers.

So the dots ultimately connect from weak environmental regulations to increased premature births to more obesity to higher health care costs to fewer jobs.

All these years we've thought we had to choose between less pollution or more jobs. But premature babies are just one of many ways pollution drives up health care costs, and there are jobs to be had in reducing pollution. As Environmental Working Group scientist Tim Kropp said, "We don't have to sacrifice our children's safety for jobs."

Kevin Lamb writes for the Dayton Daily News. E-mail:

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