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Hospitals Urged to Track Quality in Obstetrics

Cheryl Clark, for HealthLeaders Media, February 2, 2012

"Until recently, the late preterm infant has been overlooked because of assumptions that most of these infants have little to no risk for long-term morbidities," said Steven Benjamin Morse, MD, and colleagues in a 2009 paper published in the journal Pediatrics.

"However, several recent studies for late preterm, term infants have documented increased short-term medical risks during their birth hospitalization (e.g., respiratory distress, hypoglycemia, temperature instability, hyperbilirubinemia) and higher rates of readmission to the hospital after the birth hospitalization compared with term infants," he wrote.

The human toll of developmental problems that come to these babies aside, money of course is a big issue. "For the commercial (insured) population, the non-governmental payers and employers, (labor and delivery care) constitutes about 20% of the cost," says Barbara Rudolph, the Leapfrog Group's senior science director.

"This issue, childbirth, is one that's specifically a working person's issue," as opposed to a government payer's, although Medicaid is taking steps to include provider reporting of 37-39 week elective deliveries as well.

Now, however, awareness campaigns are underway, like those from the Childbirth Connection and the March of Dimes, which are attempting to correct the pervasive myth that a fetus is full-term, more or less, at 37 weeks.  Proponents of awareness make the crucial point that the date of conception can be off by a few weeks, so fetal development believed to be 39 weeks might really be 37.

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