Although the incidence of RDS for whites remained stable during the two time periods, the study found the mortality rate for these newborns dropped 66 percent. In black very low birth-weight infants, the incidence of RDS rose slightly from 60 to 65 percent during the two time periods. However, Hamvas said the death rate for these newborns fell by only 11 percent.

Hamvas said the study shows there are a variety of other reasons premature infants die. "Because of this effective therapy, we have reduced one cause of death. But we're now unmasking other types of problems very low birth-weight infants might have," said Hamvas.

These problems, he said, may be attributed to a combination of biological, social and environmental factors such as infection, adolescent pregnancy or access to prenatal care.

Overall, the researchers said trying to prevent premature births is the most effective way to save babies. Hamvas suggested that understanding the causes of pre-term labor, preventing teenage pregnancy, and improving access to prenatal care and education programs may help reduce premature births and deaths related to prematurity.

"We've made great strides with our technology and treatment, but these advances may not result in greater social equity," Hamvas said. "The emphasis should be on preventing these babies from getting here early."
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Contact: Diane Duke
duke@ibc.WUSTL.edu
314-286-0111
Washington University School of Medicine
20-Jun-1996

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