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Premature Births a Growing Concern

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Milwaukee Journal Sentinel


MILWAUKEE - Nathan Frost weighed less than 2 pounds when he was born.

He had his first surgery at 6 days old to close a connection between his lungs and aorta, improving blood flow through his body.

He had a second surgery at 13 days old to repair damage to the lining of his intestines, a risky surgery that nearly ended his life.

After his recovery, he had a third surgery at 72 days to complete the intestinal surgery and a fourth surgery less than two months later to place a feeding tube.

Nathan left the hospital at 16 weeks and one day, weighing 6 pounds, 1 ounce.

"Nathan is our million-dollar child," said his mother, Elizabeth Frost. "Even if I thought that I would have been bringing him home, I never would have thought that he'd be this energetic."

Elizabeth and her husband John's "miracle baby," who was born four months premature, is now 14 months old.

Nathan has had three additional surgeries, but he's eating well, playing more and enjoying the books his parents read to him.

A report released last week by the March of Dimes found that hospital charges for babies born prematurely or with low birthweight totaled an estimated $13.6 billion in 2001.

In comparison, hospital charges for all infants - including healthy babies - totaled $29.3 billion that year.

Nathan's medical expenses have cost "well over a million dollars" but have been covered primarily by John's military insurance and Medicaid, Elizabeth Frost said.

Last year, the National Center for Health Statistics found that the percentage of U.S. babies born prematurely, defined as fewer than 37 weeks of gestation, rose to nearly 12 percent in 2001, the highest level since officials began tracking this category 20 years ago.

In a related finding, the portion of babies born dangerously small also rose, to 7.7 percent in 2001, an increase of 13 percent since the mid-1980s.

Some of the increases can be traced to the higher number of multiple births; in these cases, babies tend to be born before their due dates and are smaller than other babies.

Mothers 30 and older and women who use certain fertility treatments - the numbers in both groups are on the rise - are more likely to have twins, triplets and even higher multiples.

Wisconsin saw an increase in the percentage of low-birthweight babies - those weighing less than 5.5 pounds - from 6.1 percent of all births in 1991 to 6.6 percent in 2001, according to the March of Dimes. In addition, 11 percent of babies in the state were premature in 2001, compared with 9.6 percent in 1991.

"Any kid under 26 weeks is going to have problems," said Mary Mishefske, a neonatologist at St. Joseph Regional Medical Center.

The most common are lung complications, such as respiratory distress syndrome, a breathing problem that results from lack of surfactant - a substance that gives fully developed lungs the elastic qualities required for easy breathing, she said.

Premature infants also are at risk for eye disease, infection and respiratory syncytial virus, or RSV, the leading cause of lower respiratory tract illness between October and May, Mishefske said.

Patent ductus arteriosus, or PDA, a heart problem in which the large blood vessel doesn't close at birth, and necrotizing enterocolitis, an inflammation that damages the lining of the intestine, are also common among premature infants, she said.

Fraternal twins Trent and Sam Christensen were born weighing 2 pounds, 2 ounces and 2 pounds, 5 ounces, respectively.

The boys, born at 27 weeks, had respiratory distress syndrome. Sam also needed surgery for his PDA and eyes. Though Trent was born with one eye still closed, he had minimal complications, said his mother, Jennifer Christensen, 34, of Pleasant Prairie, Wis.

The babies spent 11 weeks in the hospital. Their mother was hospitalized seven weeks for her incompetent cervix - a cervix that is too weak to stay closed during pregnancy - starting when she was 20 weeks pregnant.

The medical bills totaled about $700,000 before insurance, Christensen said.

"The costs just don't end when you carry them out of the hospital," she said. "The medications, the tests they need, the additional expenses of the family, the expenses just keep adding up."

Trent and Sam, now 2, weigh 30 pounds and 25 pounds, respectively. Sam uses a nebulizer to deliver his medication for breathing, though he hasn't been diagnosed with asthma. They're both receiving speech therapy and can now count to three and say their ABCs, Jennifer said.

"These tiny miracles have such a strong will to survive," she said. "As a parent, you don't want to give up hope. You have to believe."


(c) 2003, Milwaukee Journal Sentinel. Distributed by Knight Ridder/Tribune News Service.

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