In-Depth: Sen. Lamar Alexander (R-TN) introduced this bill to reduce infant deaths and improve infant health by continuing research and education programs aimed at preventing preterm births:
“In Tennessee, 11 percent of infants are born prematurely, putting them at an increased risk of complicated health problems. Since 2006, [the PREEMIE Act] has helped researchers, doctors, and parents prevent premature births, so it is important that we continue our work to give more babies the chance for long and healthy lives. This legislation includes updates to account for the opioid crisis, which has led to babies being born with neonatal abstinence syndrome, and to support the expectant mother—so that she has a healthy pregnancy and her baby is born healthy.”
Original cosponsor Sen. Michael Bennet (D-CO) added that premature births are a national issue, and the PREEMIE Act funds important research and education that also combats the opioid crisis:
“About 1 in 10 babies was born premature in 2016… We must reauthorize this bipartisan law to continue and expand on the important research and education that was started in 2006 as a result of the PREEMIE Act. This reauthorization will also combat the opioid crisis with a focus on screening and treatment for substance use disorders, so that mothers and babies can receive the care they need. Every child deserves a healthy start in life, and this law will help ensure that.”
March of Dimes supports this bill. Its President, Stacey D. Stewart, says passage of the PREEMIE Act would reaffirm the U.S.’ commitment to ensuring healthy pregnancies:
"Preterm birth continues to be an under-recognized and under-appreciated crisis in maternal and child health. Today, one in every 10 U.S. babies is born too soon, placing them at risk for a range of health consequences. Passage of the PREEMIE Act reaffirms the Senate's commitment to ensuring that every pregnancy is healthy and every baby gets the best possible start in life."
In a letter to Sens. Alexander and Bennet, March of Dimes and a coalition of maternal and child health organizations wrote about the cost of preterm birth in the U.S.:
“Preterm birth is the leading contributor to infant death, and those babies who survive are more likely to suffer from intellectual and physical disabilities. In addition to its human, emotional, and financial impact on families, preterm birth places a tremendous economic burden on our nation. A 2006 report by the National Academy of Medicine found the cost associated with preterm birth in the United States was $26.2 billion annually, or $51,600 per infant born preterm. Employers, private insurers and individuals bear approximately half of the costs of health care for these infants, and another 40 percent is paid by Medicaid.”
In their letter, March of Dimes and the other organizations also noted racial disparities in maternal health outcomes and the recent rise in preterm birth rates from 2015-2018, both of which warrant renewing the U.S.’ efforts to ensure healthy pregnancies:
“The original PREEMIE Act (P.L. 109-450) brought the first-ever national focus to prematurity prevention. For several years after its passage, preterm birth rates dropped by small but significant increments. Unfortunately, for the past three years, preterm birth rates have once again risen. In particular, troubling racial disparities in preterm birth persist, with black women experiencing preterm birth rates more than 50% higher than white women. Clearly, our nation must redouble its efforts to ensuring that every pregnancy and baby is as healthy as possible.”
Although new technologies have helped raise the survival rates for babies born extremely prematurely, they haven’t significantly improved the chances for these babies to grow up without serious impairment. This has led some neonatologists and other medical professionals to question the definition of survival for micro preemies and whether intensive medical intervention is always the best choice given their continued medical needs, specialized care needs, and the expenses their families and society incur. An article published by the American Academy of Pediatrics in 2006 calls the use of neonatal intensive care on infants born before 27 weeks of gestation a “fundamental controversy in neonatology.”
John Pardalos, a neonatologist at the University of Missouri Women’s and Children’s Hospital in Mid-Missouri, points out that there are significant costs associated with extreme preemies’ survival:
“As more of these babies are surviving now, we are creating a generation of babies that will need more help in elementary school and in high school because of the learning issues that they might have or the physical disabilities they might need to overcome when they get older… Yes, I think we are creating more disabled kids, but I think we also have a lot of kids that are completely normal, even though they started little, and are full, participating humans in our society 20, 30, 40 years down the road. So it's hard for me to say ‘You're going to be great and you’re not.’ We just have to take the chances and treat everyone like they will be able to survive and do well on their own in the future.”
This bill passed the Senate unanimously with an amendment and has been referred to the House Committee on Energy and Commerce. It has the support of 12 Senate cosponsors, including nine Democrats and three Republicans, and a range of maternal and child health organizations, including the American College of Obstetricians and Gynecologists, American Academy of Pediatrics, Association of Maternal and Child Health Programs, Children's Hospitals Association, and First Focus.
Of Note: Sen. Alexander introduced the PREEMIE Act in 2003, and it was first signed into law in 2006 and reauthorized in 2013. It needs to be reauthorized again, or else many of its programs will expire. After the original PREEMIE Act’s passage, the U.S.’ preterm birth rate dropped each year, falling to a historic low in 2014.
Every year, over 380,000 infants are born preterm in the U.S. Premature birth and its complications are the leading cause of infant death in the U.S., and premature infants who survive are more likely to suffer from intellectual and physical disabilities than infants born at full term.
In 2007, the Institute of Medicine estimated that premature birth in the U.S. costs $26.2 billion a year. This includes:
$16.9 billion in medical and health care costs for the baby;
$1.9 billion in labor and delivery costs for mothers;
$611 million for early intervention services;
$1.1 billion for special education services; and
$5.7 billion in lost work and pay for people born prematurely.
Premature babies may have a harder time in school than babies born on time, as they’re more likely to have learning and behavior problems throughout childhood, potentially having low test scores, having to repeat grades, and needing special education services. One in three children born prematurely needs special school services at some point during their school years, costing $2,200 a year per child.
Later on in life, premature birth can affect a person’s ability to work, the amount of work they can do, or both. Some adults who were born prematurely may have long-term health conditions that can affect their ability to work.
Summary by Lorelei Yang(Photo Credit: iStockphoto.com / Yobro10)