Rising age of mothers and IVF leading to earlier births

MORE BABIES are being born prematurely because of the rising age of mothers and increased use of in-vitro fertilisation treatment, among other factors, a leading neonatologist has said.

Dr John F Murphy, clinical lead of the Health Service Executive’s neonatology programme, was speaking at the launch of a report by a charity calling for development of a national neonatal health policy.

“The Irish prematurity rate of 6 per cent is rising steadily due to a series of factors including increased maternal age, IVF treatment, multiple births, obesity and other dietary factors and the catch-all effect of greater urbanisation,” he said.

The older age of mothers resulted in more hypertension affecting the nutrition and blood flow to the infant and meant doctors had to intervene early, Dr Murphy said.

The rise in IVF led to more twinning, which increased prematurity. General increased urbanisation and nutrition were also factors. The increase in the birth rate was another factor in the rise in premature births, Dr Murphy added. Irish birth rates rose 40 per cent between 1999 and 2009.

The increase in overall births “happened quite quickly” and “caught us all out, as it’s hard to legislate for”, he said.

The report by the charity Irish Premature Babies and by the European Foundation for the Care of Newborn Infant called for the introduction of a national public policy on neonatal health. The report marked World Prematurity Day yesterday.

“The report clearly shows that while the national neonatal service in Ireland is good, the implementation of official clinical guidelines is often fragmented and localised,” Dr Murphy said.

One of the aspirations of the service for premature babies was to extend the inter-hospital transport system so they could be taken to bigger units 24 hours a day, he added.

More cohesion in the system and streamlined policy was another aspiration that would help, because every hospital had its own standards, he said.

Mandy Daly, family liaison manager with Irish Premature Babies, said: “It’s clear from the report that a national neonatal health programme governing all aspects of neonatal health in Ireland is essential in the delivery of a structured and uniform standard of care.”

The report raises concern about the lack of policy on the provision of prenatal screening and the role of sonographic and serum screening for abnormalities.

Many infants whose birth weight and gestation period fell outside the remit for automatic follow-up were failed by aftercare, the report added. Potential high- risk developmental issues became the responsibility of the family or GP, it said.

Among the other recommendations of the report are the employment of more consultant neonatologists, increased awareness of premature birth and a national prevention and screening programme for pregnancies.