march of dimes national prematurity campaign and the preemie act (public law 109- 450) dr. jennifer...
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March of Dimes National Prematurity Campaign and the PREEMIE Act (Public Law 109-450)
Dr. Jennifer L. HowsePresident, March of Dimes
Secretary’s Advisory Committee on Infant Mortality
June 14, 2007
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Prematurity is Common
467,201
476,250480,812
499,008
508,356
520,000*
450,000
460,000
470,000
480,000
490,000
500,000
510,000
520,000
530,000
2000 2001 2002 2003 2004 2005
U.S. Babies Born Premature 2000-2005
*2005 preliminary birth data provided by the National Center for Health StatisticsSource: National Center for Health Statistics, final natality data
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Preterm Births (<37 weeks)
by Maternal Race/Ethnicity, US, 2004
Percent
13.7
17.9
11.5 10.512.0 12.5
0
5
10
15
20
White Black Native American Asian or PacificIslander
Hispanic All Races
All race categories exclude Hispanic births
Source: National Center for Health Statistics 2004 final natality data
Prepared by March of Dimes Perinatal Data Center, 2006
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Prematurity is Serious
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Prematurity is Costly Annual Societal Economic Costs Associated with Preterm Birth, US, 2005
Medical Care Services $16.9 billion (65%)
Lost Household and Labor Market Productivity $5.7 billion (22%)
Maternal Delivery $1.9 billion (7%)
Special Education Services $1.1 billion (4%)
Early Intervention Services $611 million (2%)
Preterm is less than 37 completed weeks gestation. Source: Institute of Medicine. 2006. Preterm Birth: Causes, Consequences, and Prevention. National Academy Press, Washington, D.C. Published and unpublished analyses. Prepared by the March of Dimes Perinatal Data Center, 2006.
Total Costs = $26.2 billion
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Average First Year Medical Costs and
Average Length of Hospital Stay, US, 2005
Average Length ofHospital Stay
Average First YearMedical Costs
Term
Preterm
1.5 Days
13 Days
$3,325
$32,325
Preterm is less than 37 completed weeks gestation. Term is > 37 weeks.Medical costs include both inpatient and outpatient care.Source: Institute of Medicine. 2006. Preterm Birth: Causes, Consequences, and Prevention. National Academy Press, Washington, D.C. Published and unpublished analyses. Prepared by the March of Dimes Perinatal Data Center, 2006.
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Cost of Prematurity to Employers
Full-termNo
Complications
Delivery w/diagnosis
Of Prematurity
Inpatient $1,210 $35,034
Doctor’s Office
$1,518 $6,079
Drugs $102 $497
Total $2,830 $41,610
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March of Dimes National Prematurity Campaign
Goals
2.
1.
0
2
4
6
8
10
12
14
1981
1983
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
Campaign Goal I:Reduce the rate of preterm birth from 12.1% in 2002 to 7.6% in 2010, in accordance with the Healthy People 2010 objective
12.1%12.7%
9.4%
7.6% - HP2010 Objective
Percentage of live births less than 37 completed weeks gestation.Source: National Center for Health Statistics, Final natality data, 2005 data is preliminary.
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44%44%41%42%41%
35%
54%51%50%
55%53%
41%
20%
40%
60%
2001 2002 2003 2004 2005 2006
Total Women 18-44
Campaign Goal II: Raise awareness of the problems of prematurity
Percent saying premature birth is a very or extremely serious problem
32%
26%
March of Dimes National Prematurity Campaign
Goals
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March of Dimes National Prematurity Campaign Aims
• Raise public awareness
• Educate women of childbearing age
• Support affected families
• Assist practitioners to reduce risks
• Support new research on etiology
• Advocate for health care access
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Prematurity Research Initiative
• Initiated in 2005 focusing on genetics and genomics
• $7.7 million in funds awarded
• Better understanding of the etiology of preterm birth can bring us closer to actual prevention
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Pilot Sites
• California Pennsylvania
• Florida South Carolina
• Illinois Texas
Cooperative Agreement with the CDC: Reducing Disparities in Premature
Birth
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Healthy Babies are Worth the Wait
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Singleton Preterm Birth Rates by Participating Hospital
14.3%15.4% 15.5%
12.8%
15.0%
0%
5%
10%
15%
20%
King'sDaughter's
Med Ctr
RegionalMed CtrHopkinsCounty
Univ of KYHospital
InterventionHospital
Total
Project Goal
Preterm is less than 37 completed weeks gestationSource: KY Dept of Health (2004 Data)Prepared by the March of Dimes Perinatal Data Center, 2007
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Prematurity Awareness Day November 13, 2007
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Prematurity Awareness Day
Akron Children’s Hospital
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I Want My 9 Months
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Thank you for your attention
Additional Resources
Pregnancy and Newborn Health Education Center
www.marchofdimes.com www.jjpi.com
this continuing education presentation is sponsored by the
March of Dimes - Johnson & Johnson Pediatric InstituteGrand Rounds Program
as part of the
March of Dimes National Prematurity Campaign
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NICU Family Support
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NICU Family Support
Program Sites*
Open Sites Opening in 2007
* As of 4/17/07
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Access to Care
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Uninsured Low Income Children 1997-2005
22.3%21.5%
20.1% 20.0%
18.0%
15.8% 15.9%15.2% 14.9%
1997 1998 1999 2000 2001 2002 2003 2004 2005
SCHIP Reauthorization
Source: CCF analysis of NHIS
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PREEMIE P.L. 109-450
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PREEMIE Passage
• Introduced 2003; reintroduced 2005
• Unanimously passed Senate August 1, 2006
• Unanimously passed House December 9
• Signed by President into law December 22
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PREEMIE Purpose
• Reduce the rates
• Evidence-based standard of care
• Reduce infant mortality and
disabilities
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1. CDC Research
• Expansion and intensification of overall
research portfolio
• Link PRAMS data with maternal-infant
clinical and biomedical information
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2. Education
Authorizes grants for demonstration projects
• To test and evaluate educational outreach and materials
• To improve treatments and outcomes
• To respond to informational and emotional needs of families
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3. Interagency Coordinating Council on Prematurity and Low Birthweight
• Greater collaboration across HHS
• Annual report to the Secretary and
Congress
• Oversee the coordination of the
implementation
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4. Surgeon General’s Conference on Preterm Birth
• Public-Private research and education agenda
• Target date: December 2007
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PREEMIE Implementation
$8 million $8 million
CDCCDC
$1 million $1 million SGSG
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What can SACIM do?
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Prematurity—Common, Serious, Costly