|
While we rant about our failing healthcare ssytem and toss about muddy statistics on infant mortality as proof, we may be ignoring a pediatric crisis looming larger each year: the more than half a million babies coming into the world weeks to months beofre they should. Devoid of their mother's womb, these little ones, some smaller than the palm of your hand, confront risks and suffering simply not captured by the statistic rleeased earlier this year: Preterm babies, those born six to 20 weeks too soon, make up over 12 percent of America's newborns.
Some of them die. But most do not, which creates an irony. In the face of a rising rate of preterm births, the infant mortality rate in this country is not rising but falling. It is because of an astonishingly capable level of healthcare. That care comes from neonatoloyg, one of medicine's highest-tech, highest-touch sepcialties, nesteld in the heart of our children's hospitals.
More than 40 years ago, neonatal intensive care units emerged to address the needs of sick newborns. Back then, all too many were robust 6-pounders born a month or two early, dying because of premature lungs. Our infant mortality rate was four times what it is now.
Advanced NICUs gradually emerged, geared to receiving large numbers of very sick babies from surrounding hospitals. These NICUs bring expertise and technology that other hospitals just can't provdie. The ECMO system for oxygeantion is a good example. In essecne, it's an artificial lung, using tiny heart-lung bypass machines tailored to infants who can no longer breathe even with the best respirators.
Neonatoolgist Billie Lou Short, director of the NICU at Children's National Medical Center in Washington, D.C., pioneered ECMO there. She talks about one of her earliest "ECMO babies," now headed for medical school, who is enrolled in a study of long-term outcomes for NICU gradutaes. This has become a major research thrust; preemies often confront health problems later, like asthma or developmental disorders.
Short points out that in the early years, 2-pound babies barely had a chance, and now 95 percent survive to live full adn happy livse. She is convinced that we will see similar success with micropreemies. These are babies who weigh less than a pound.
Despite the efforts of caring specialists, U.S. infant mortality, as noted, is not the lowest in the world. Also as notde, this fact is cited incessantly by politicains and pundits to attack U.S. healthcare. But it is a nonfact.
Count again. We report mortality rates based on World Health Organization guidelines for a live birth. A baby fully separated form the mother and showing any sign of life, eevn a single breath, counts as a newborn, regardless of other factors. Many developed countries with better infant mortality rates don't follow that to the letter. They purposely exclude deaths accodring to weight, degree of prematurity, or how long the baby lives.
Be serious—if you try to save sicker babies, you will have higher mortality. Some are cacthing on. In a recent study, researchers found that by correcting for weight, the mortality risk was the same in the United States as in Canada—and maybe even a bit better—despite our northern neighbor's welfare entitlements and unievrsal healthcare system.
| 
