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    Number of low-weight babies on the rise

    According to study by the Healthy Start Coalition, factors that affect birth weight include race, socioeconomic status and prenatal care.

    [Times photo: Andrea Bruce Woodall]
    Sebastian Socrates Lee O'Neill is touched by his mother for the first time since his birth on Tuesday, almost two months before his Jan. 31 due date. He weighed only 2 pounds, 12 ounces at birth.


    © St. Petersburg Times, published December 8, 2000

    Despite good prenatal care in Pinellas County, the number of mothers having low birth-weight babies continues to climb.

    Today, 8.2 percent of the babies born in Pinellas County weigh less than 5 pounds 8 ounces, up from 7.7 percent in 1992-1994. Pinellas County also outstrips the national average of 7.5 percent.

    The trend is significant because low birth-weight babies often have more health problems than bigger newborns. A study to be released today provides clues about what may be causing the increase, but doesn't solve the medical mystery.

    "It's just something that requires our continual exploration," said Debra Bara, executive director of the Healthy Start Coalition of Pinellas, Inc., which conducted the study. "We don't know the answers right now, (but) we're trying to find out."

    If researchers want to decrease infant mortality, they must find out why children are being born small. If they break that code, it could lead to healthier lives.

    One piece of the puzzle is the rising number of multiple births. Twins and triplets tend to be small infants and account for 60 percent of the increase in low birth-weight births, but what troubles health professionals is that they don't know what's happening with the rest.

    Researchers also don't know what to do about a racial gap between white and black women. About 13.9 percent of black mothers have an underweight child. It is unclear why this happening, although previous research suggests that socioeconomic issues and the stress of dealing with racism may be to blame.

    Babies smaller than the 5-pound 8-ounce threshold established by the World Health Association are at risk for learning difficulties, cerebral palsy, neurological problems and other maladies.

    Those ailments come at a cost, said Dr. Claude Dharamraj, assistant director of the Pinellas County Health Department.

    Deliveries of low birth-weight babies are more expensive. The babies also may require special medical treatment and special education.

    "Every time you have a low birth-weight baby, it will cost society," Dharamraj said.

    The Healthy Start study springboards from previous data collected by Choices for Community Health in 1995 and was funded by the Juvenile Welfare Board.

    Researchers examined the medical records of 1,000 infants -- 500 healthy babies and 500 low-birth-weight babies. It also examined their mothers' prenatal care and data on their deliveries.

    Using that information, researchers were able to identify some factors that may affect the weight of newborns.

    The most startling data they came across showed a geographic difference: Mothers in the southern part of the county are more likely to be single and black, while their north-county counterparts are more like to be married and white. Northern county mothers are also more like to be smokers, placing their unborn baby at risk.

    The data blur the socioeconomic line, making it more difficult to address the issue.

    "We can't necessarily do the same thing in both parts of the county," Bara said.

    Smoking also complicates the issue. About one-third of all the participants in the study who reported smoking during their pregnancy had low-birth-weight infants.

    Still, there was some good news.

    There is evidence that a Heathy Start prenatal screening, which asks questions about health care and socioeconomic status, is effective in identifying women at risk for delivering low-birth-weight infants and developing giving clues to preventive measures.

    Other studies have shown that single mothers may be at risk because they don't have a strong support network. Stress and lack of nutrition also play a role, as does domestic violence, Dharamraj said. Today, about 50 percent of expecting mothers are screened. Healthy Start wants to see that number double. The organization recommends that mothers ask their doctors for a screening. Expectant mothers also should stop smoking while they are pregnant.

    Healthy Start also recommends that health organizations explore the concept of twin clinics, which could help boost the weight of twins and triplets by making sure mothers receive the proper nutrition, follow-ups on missed doctor appointments and a single medical doctor who coordinates each mother's care.

    "We've got to be able to figure this out," Bara said, "to be able to give kids a shot before they're born."

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