Thursday, March 23, 2006

Chicken Little Science

While poking about I bumped into an interesting article concerning the rise in preterm births. Since all of my pregnancies ended on the early side I was intrigued by the story.

First a little background. Jake was born at bang on 38 weeks at 7lbs and 11oz (heh, 7-11 an easy number to remember). Nate hung tough for a little longer and came at 38 ½ weeks weighing 8 lbs 3 oz. Both boys were healthy (except for jaundice on Jake’s part) and robust. If they had gone onto 40 weeks they would have been pushing 9 lbs each. Ouch!

Max and Rebecca are of course special. Term for twins is defined at about 38 weeks. The lungs mature at an earlier gestational age with multiples and a greater burden is placed on the mother’s body to maintain a multiple pregnancy. They were born at 36 weeks. I was induced, but since I was already at 5 cm they were coming that day regardless. I’m very proud to say that they both went to the “big baby” nursery and bypassed the NICU altogether.

All of my babies came home when I did and there were no c-sections. It is quite possible that the calculated due date is not accurate and I may have been shortchanged by a week. The size and health of my children incline me to think that way.

Now back to the article.

My initial reaction upon reading the headline was “What else is new”. The c-section rate in the US runs at about 25% and a number of them are the result of a scheduled delivery. There has also been a rise in maternal age and this too can result in a shorter pregnancy from the increased probability of complications (growing babies is hard work and is very taxing on the mother). There has also been a rise in pregnancies that are the result of reproductive assistance technologies, which often result in multiples and pregnancies in less than ideal conditions. All of which result in a trend towards shorter pregnancies.

The article did touch on the c-section rate, but said some other factor must be at work too and that more research was needed. The study leader never mentioned the possibility of the other factors that I outlined above, which I find to be rather short sighted.

This article is classic chicken little science. There is a great and terrible problem, we don’t know why, give us more money to do more research (even though an examination of existing research could probably answer the question). This kind of science irks me to no end. If the study leader had a made a simple list of what can cause preterm labor and looked at factors such as the rise of planned c-sections, multiples and maternal age the study would have most of the research it needed.

Now I’m not belittling the very real risk of pre-term deliveries. There are some very significant risks associated with pre-term birth and the costs are staggering to the family and infant that are both financial and physical. I would just like to see a rational approach to be taken with such studies. I know what I want is not terribly sexy and does not drum up more funds, but it is a much better approach to get to the truth of the matter.

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