
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, June 25, 1995                   TAG: 9506260092
SECTION: EDITORIAL                    PAGE: F-2   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

UNHEALTHY BABIES

EVERY YEAR, 40,000 babies die in the United States, and the great majority - three-quarters - were born weighing too little. Yet, identifying the causes of low birth weight to determine preventive actions is proving frustratingly difficult for medical researchers.

The United States has not only an advanced medical-care system, well-trained providers and widely available prenatal care, it has an unsurpassed record in saving the lives of the tiniest infants born. It has lowered the infant mortality rate. But the rate remains higher than that of many other developed nations, including Japan and Germany.

And the improvement is due to advances in neonatal intensive care and in the drugs available to help premature babies breathe. These are wonderful achievements. They are extremely expensive, however, accounting for more than one-third of the $11 billion spent annually on infant health care, by one estimate. And the tiniest infants saved often suffer long-term health and development problems.

Reducing the numbers of babies born too soon or simply too small would be a better alternative. Unfortunately, as the Center for the Future of Children notes in an exhaustive report on low birth weight, scientists have been more successful in developing technologies to rescue babies than in figuring out causes and preventive measures.

This doesn't mean they have learned nothing. They do know, for instance, that cigarette smoking retards fetal growth and accounts for as many as 20 percent of the cases of low birth weight. Low maternal weight gain and low prepregnancy weight are risk factors. Black babies are twice as likely as white to have low birth weight, be born prematurely and die at birth.

In deciding priorities for increasingly scarce funding, emphasis should be put on finding out why babies are born prematurely and, where a cause is known, how to intervene effectively. Programs to help pregnant women stop smoking might be tied to prenatal care, for example.

Clearly, more intervention is needed. But more non-medical intervention may prove more effective in lowering the low birth weight. And, as scientists are wont to say after finishing one study, more study is needed.

by CNB