Double is trouble when caring for premature babies

Julie RobothamMarch 10, 2009 - 8:02AM

Care facilities for the most fragile premature babies are under mounting pressure in NSW, as a baby boom collides with rising numbers of twins - the result of fertility treatment and the increasing age of new mothers.

... half of the state's neonatal intensive care units were now regularly closed to new infant patients, as unpublished figures ... show twins and higher multiple births made up 22.5 per cent of ... admissions in 2006 - despite in-vitro fertilisation clinics' insistence they are reining in multiple births ...

NSW's birth rate leapt 3 per cent in 2007 alone, to 93,583 births ... Demand for intensive care has also been rising steadily, by 14 per cent between 2001 and 2006, when there were 2296 admissions.

... twins conceived in profitable private clinics frequently fell to the public hospital system for care when they were born sick and fragile. "The cost to the public purse is huge and the people who are running [fertility clinics] are very wealthy."

Associate Professor Evans, who runs the hospital's newborn intensive care unit, said twins were born on average at 37 weeks of pregnancy, and those born before 35 weeks could suffer feeding and breathing problems. Along with the overall rise in births, he said, "there's no doubt [twins] create a significant service load for us".

Doctors said the state's 10 units for the sickest newborns were now often on "code red" - meaning they cannot accept any more infants ... "the state is full almost every day," said the head of another neonatal department ... Our safety margin continues to be diminished." But hospitals would always find a place for a premature infant among the 88 beds statewide, he said. .... Michael Chapman ... at ... IVF Australia, said the proportion of IVF births that were twins or triplets was falling as single embryos were replaced in most cases ...

IVF clinics did not benefit financially from producing twins over single pregnancies, said Professor Chapman ...

Lillian and Erin, now three, were born at 30 weeks, after Mrs Carswell's blood pressure soared as a result of pre-eclampsia. The girls needed hospital care for two months but have avoided long-term consequences.

An interesting debate. No doubt as medical technology increases, we will be able to keep younger and younger babies alive, with increasing qualitity of life.

I wonder what impact effective preconception care may have on this issue. If women accessed effective preconception care that increased their ability to conceive without IVF, then this could well see fewer preterm babies in our neonatal nurseries.