Hospitals worry as they care for more low-weight newborns

EVERETT — Danica Nicolici weighed just 2 pounds, 3 ounces at birth.

Problems during her mother’s pregnancy meant she needed to be delivered 10 weeks prematurely.

Danica has spent the first six weeks of her life in the infant intensive care unit at Providence Everett Medical Center, splitting time between an isolette or incubator to keep her warm, and being gently wrapped in the arms of her mother, Chrissy Nicolici.

Although Danica now weighs 4 pounds, 5 ounces, doctors say it could be another two weeks before Nicolici and her husband, Adrian, can bring their daughter home.

Yet for all this, Chrissy Nicolici said she feels lucky.

Prenatal care helped detect a string of problems that kept cropping up during her first pregnancy: high blood pressure, pre-eclampsia (a leading cause of premature births) and liver problems.

When doctors detected that Danica’s growth was not progressing normally, they decided it was time to deliver.

“I felt fine the whole pregnancy,” Nicolici said. “If I had no prenatal care, I would have continued on until contractions.”

Low birth weight in babies can be caused by a number of problems, such as issues with the mother’s health and lack of prenatal care, putting children at higher risk for physical and developmental problems and death.

The increasing number of infants who don’t meet the standard of a healthy birth — weighing less than 5 pounds, 8 ounces — is a warning sign about infant health, according to a recent national study.

It’s a trend that’s being seen not only nationally and statewide, but in Snohomish County, too, said Dr. Frank Andersen, medical director of services for women and children at Providence Everett Medical Center.

“The bottom line is I think it’s a warning flag,” he said. “We’re talking about a lifetime of increased medical risks that have been linked to low birth weight,” including cerebral palsy and developmental delays.

The latest information on low-birth-weight babies was included in a Kids Count study by the Annie E. Casey Foundation.

Washington has the nation’s lowest rate of low-weight births. However, that number increased from 5.6 percent of births to 6.1 percent between 2000 and 2005, the latest data available.

It’s part of a national trend that has the rate of low-weight births reaching its highest level in 40 years, said Laura Beavers, a coordinator for the national Kids Count program, which produced the study.

The rate of increase in Washington slightly outpaced that of the nation, she said.

It’s too soon to know exactly what’s causing the increase. The problem is often associated with poverty, inadequate nutrition and smoking during pregnancy, said Lori Pfingst, an assistant director for the Kids Count program in Washington.

There are big differences among races and ethnic groups in the percentage of low-birth-weight babies, she said, with black, American Indian and Asian mothers having some of the highest rates in Washington. Hispanic women are slightly more likely than Caucasian women to have babies with low birth weights, according to the state Department of Health.

Researchers have linked a lack of adequate prenatal care to low birth weight, Pfingst said.

In Snohomish County, 14 percent of women giving birth between 2003 and 2005 did not get adequate prenatal care, according to the Snohomish Health District.

Women younger than 18 and American Indians, blacks, Asians and Pacific Islanders are the most likely to receive inadequate prenatal care, according to the public health agency.

Geographically, women living in Everett and the Highway 99 corridor were most likely to receive inadequate prenatal care.

The number of low-birth-weight newborns delivered at Providence Everett Medical Center jumped from 202 to 269 between 2006 and 2007.

The number of women giving birth there who had received insufficient prenatal care more than doubled from 96 in 2004 to 203 in 2007.

A declining number of health-care providers who deliver babies, such as obstetricians and nurse midwives, is one more factor that can keep women from getting the prenatal care they need, said Dr. Gary Goldbaum, health officer for the Snohomish Health District.

Prenatal care “is one of the most important clinical prevention strategies we have to both maternal health and infant health,” he said.

“We do see a lot of low-birth-weight babies,” said Christie Tipton, manager of children and family services at Providence Everett Medical Center.

“You have to work on those areas of delay at the most optimal time,” she said, which is before the children are 3 years old.

These babies are monitored for problems in muscle development and walking, crawling and sitting, she said.

“The good news is with the right intervention, you can minimize the long-term effects.”

Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.

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