Category Archives: Prematurity

Infections during Pregnancy

February is International Prenatal Infection Prevention Month. No one ever wants to acquire any kind of infection, but pregnant women especially want to avoid infection in order to protect themselves and their babies.

One of the more common infections in pregnancy is Group B Strep. Up to 25% of pregnant women may have it. Pregnant women are tested for it during their routine prenatal care between 35 and 37 weeks gestation. In pregnancies with a positive result, antibiotics are given during labor to prevent spread of the infection. It is important for everyone to be tested for Group B Strep during each pregnancy.

Many people have heard that pregnant women should avoid certain soft cheeses, some deli meats, and other foods. This is due to the risk of listeriosis, another infection that can occur in pregnancy. Foods that are contaminated by the bacteria listeria can cause listeriosis. These foods may include those mentioned above as well as hot dogs, sprouts (bean sprouts, for example), and unrefrigerated melon. For more information on listeriosis prevention and high risk foods, check the CDC website.

Most recently, Zika Virus has been a concern for pregnant women due to its potentially causing many problems during pregnancy and for babies. The best ways to protect oneself from Zika is to avoid areas where it is common (many Central and South American and Caribbean countries), to avoid exposure to mosquitoes, and to practice safe sex with any partner who could have been exposed to Zika.

For more information on Prenatal Infections, click here!

Prematurity Awareness Month

October is coming to a close, and November – Prematurity Awareness Month- is right around the corner. Premature birth is a leading cause of infant death in the United States.

Premature birth is defined as a birth occurring before 37 weeks gestation. Being born preterm can prevent many important fetal growth and developmental milestones for babies. Babies who are born preterm may spend significant amounts of time hospitalized in the NICU (neonatal intensive care unit), and they may face lifelong health and developmental problems.

In 2014, 1 in 10 babies born in the US were born premature. According to the CDC, many factors can contribute to preterm birth, including:

  • Previous preterm birth
  • Being pregnant with more than one baby (twins, triplets, or more)
  • Problems with the uterus or cervix
  • Chronic health problems in the mother, such as high blood pressure, diabetes, and clotting disorders
  • Certain infections during pregnancy
  • Cigarette smoking, alcohol use, or illegal drug use during pregnancy

For moms in Shelby County, there are resources for addressing some of these factors. 17P, a progesterone injection, is available for women who are at risk of preterm birth. The Shelby County Tobacco Prevention program can be helpful for moms who want to quit smoking. Additionally, any primary care physician or OBGYN can help mothers understand and assess their risks associated with preterm delivery and work towards having healthy and full-term pregnancies.

The March of Dimes has information regarding preterm birth and what you can do to help prevent it!

Decrease Your Risk of Preterm Birth

TDH

Decrease Your Risk of Preterm Birth

By

Rachel Heitman

Director of Injury Prevention, Infant Mortality Reduction and Death Review

Tennessee Department of Health

Did you know that 1 in 10 babies are born too early in Tennessee? In Memphis, 13.7% of all babies are born prematurely or before 37 weeks gestation. Preterm birth is one of the leading causes of infant mortality. When a baby is born prematurely, he/she might need special care in the hospital. The baby is also at risk for life long disabilities or death. Some steps that you can take to reduce your risk and improve your overall health when pregnant include:

1. Avoid alcohol and illicit drug use.

There is no safe level of alcohol use during pregnancy. Alcohol can affect the fetus throughout pregnancy. It is best not to drink at all while you are pregnant. If you did drink alcohol before you knew you were pregnant, you can reduce the risk of further harm to the baby by stopping drinking.
Illicit drug use includes use of any illegal drugs in addition to the use of prescription drugs for a nonmedical reason. Drug use can interfere with the growth of the fetus and cause preterm birth and fetal death.

2. If you smoke, STOP.

Cigarette smoke contains more than 4,000 chemicals. When you smoke during pregnancy, those chemicals build up in your blood stream, which is the source of oxygen and nutrients for your baby. If you need help with quitting, call the quit line at 1-800-QUIT-NOW (1-800-784-8669).

3. Get early prenatal care and attend all of your scheduled appointments.

Some of the largest risk factors for premature birth include high blood pressure, infections, abnormal uterus or cervix, and stress. By going to your provider early and often, these types of conditions can be tracked and monitored and possibly lead to preventing a preterm birth.
4. Learn the signs and symptoms of preterm labor.

The signs of preterm labor include pain in the belly, painful urination, decreased movement from the baby, backache, contractions, cramping, leaking fluid, increased abdominal pressure, increased vaginal discharge, vaginal bleeding, and fever. If you experience any of these symptoms, be sure to check in with your provider.

5. Ask your provider if you are a candidate for 17P.

If you have already had a preterm birth, you might be eligible for a medication called 17P. This medication is a weekly injection starting around the 16th week of pregnancy and continuing until 37 weeks pregnant. There are no known side effects for the baby. This medication has shown to lower the risk of delivering a preterm baby by as much as 33% for women that have had a previous preterm birth. If you would like more information about 17P, please talk to your OB provider.

6. Wait at least 18 months between pregnancies.

Take your time between pregnancies. Another high-risk factor for preterm birth is having less than 18 months between pregnancies. Infants conceived less than 6 months after giving birth have a 40% chance of being born premature. A longer time between pregnancies is important to help your body heal. To prevent pregnancy for at least 18 months, talk with your provider or local health department about birth control options. If you do become pregnant within this period, be sure to get early care from your provider.

7. Manage stress.

Increased stress puts you and your baby at risk for a preterm birth. Figure out what’s making you stressed and talk to your partner, a friend, family member or your health care provider about it.

8. Lead a healthy lifestyle before becoming pregnant.

If you are considering becoming pregnant, start your healthy lifestyle now. This includes exercising, eating healthy, taking a multivitamin, seeing your physician for a check-up, and getting any illnesses or chronic diseases under control
The following links provide more information on prematurity.

http://kidcentraltn.com/article/premature-babies

http://www.marchofdimes.org/premature-babies.aspx

http://www.acog.org/Womens-Health/Preterm-Premature-Labor-and-Birth

Zika Virus & Pregnancy

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Zika Virus & Pregnancy

by

Ture Carlson and Tyler Zerwekh, DrPH

Shelby County Health Dept., Environmental Health Services Bureau

There has been a lot of news coverage on Zika virus the past couple months. Most of this media coverage has been based on a potential link between Zika virus and a congenital condition or birth defect called microcephaly.

Zika virus is not new. It was first discovered in 1947 in the Zika Forest, located near Entebbe, Uganda. In the following year, mosquitoes in the Zika Forest were found to be infected with the virus, and that was when it was thought to be a mosquito-transmitted virus. Research several years later confirmed this assumption.

In May of 2015 health authorities in Brazil reported cases of Zika in which the patients had no international travel history, indicating the virus was being locally transmitted. Local transmission means mosquitoes in that area are infected with Zika virus and are spreading it to people. In November of 2015, about six months after Zika was first detected, Brazilian authorities began to notice an increase of babies being born with below normal head sizes.

Microcephaly is a condition in which the head size remains small because the brain does not develop properly. Microcephaly has been associated with other infections like cytomegalovirus, chicken pox, and rubella if the mother has contracted them during pregnancy. Zika is just another potential infection an expecting mother may contract during pregnancy (in areas where there is risk of viral transmission).

It is important to note, current research demonstrates Zika virus has not been clinically proven to cause microcephaly. However, some evidence has led to concern for pregnant women living in or traveling to areas where Zika virus is actively circulating:

  1. Increase in microcephaly where Zika is being detected
  2. Increase in microcephaly started showing up about six months after Zika started being detected
  3. Zika has been found in the amniotic fluid
  4. Zika has also been found in the brain tissue of newborns with diagnosed microcephaly

Pregnant women planning to travel outside the U.S.A. should visit the U.S. Centers for Disease Control and Prevention’s website at http://wwwnc.cdc.gov/travel/notices to find out current health issues for their specific destination. Also any pregnant women returning from international travel should inform their physician about their travel history.

Currently, there is no available vaccine for Zika virus so it is important to take precautions and avoid contact with mosquitoes.

  • Wear loose fitting long-sleeved shirts and long pants.
  • Use EPA-registered insect repellents containing DEET, IR3535, picaridin, or oil of lemon eucalyptus. The U.S. Environmental Protection Agency does not recommend any additional precautions for repellent use by pregnant or nursing women. Use insect repellents as directed.
  • Sleep and stay in air-conditioned and/or screened-in rooms.

Currently all of the cases of Zika virus being reported in the United States have been found in travelers returning from foreign countries. There is the potential for a traveler to return to Shelby County and infect the local mosquito population with Zika. In Shelby County there is one mosquito species out of the 48 different species currently known to be able to spread Zika to people, and that is the Asian Tiger mosquito.

Although the Asian Tiger mosquito can be found throughout Shelby County, it is more common in urban areas. It is a black mosquito with very visible white-sliver stripes on the legs and body. This mosquito has a couple of important behaviors.

  1. It is active during the day. The Asian Tiger mosquito is one of the few mosquitoes that will try to bite people and animals during the day. Most mosquitoes will only be active at dusk and dawn.
  2. Containers, Containers, Containers!!! The Asian Tiger mosquito will only lay eggs and grow in containers that can hold water. This includes but is not limited to tires, cans, buckets, gutters, bottle caps, and sometimes small ornamental ponds that are not working properly. The Asian Tiger mosquito will not lay its eggs or grow in large areas of standing water like swimming pools, flood plains, or ditches.
  3. The Asian Tiger mosquito is active late April/ early May until late October. It will not be found during the winter months no matter how warm it may get.
  4. The Asian Tiger mosquito does not fly far from where it developed. Odds are if it is biting you in your yard it came from your yard. It is very important, especially after a rain, to check your yard for anything holding water. Encourage your neighbors to do the same.

Everyone Loves HUGS—Have you had YOUR HUG today?

HUGS Pic2

Everyone Loves HUGS

By: Linda Busby,RN

Shelby County Health Department

901-222-9703

Everyone Loves HUGS

Have you had your HUG today?

As we know there are many different kinds of hugs ranging from the polite hug to the never-ending rocking side to side embrace hug. And just as there are so many ways to hug there are endless reasons why hugs are wanted and needed. Today I want to share HUGS with you!

What is HUGS?

HUGS is an acronym which stands for Help Us Grow Successfully. HUGS is a home-based care coordination program developed by the Tennessee Department of Health. Home visitation provides a way to help decrease infant mortality. The Shelby County Health Department HUGS program provides assessment of family needs, assistance to seek solutions for these needs, and also includes client centered education.

In an effort to reduce the infant mortality rate one of the specific focus areas for the HUGS program is educating families on the risk of Sudden Infant Death Syndrome (SIDS) by providing a safe sleep environment for infants.

Who qualifies for these services?

  • Families living in Memphis and Shelby County
  • Prenatal/postpartum women
  • Children through 5 years of age
  • Parent/guardian of the client referred to the program.
  • Families who have experienced the loss of a child less than 2 years old (due to SIDS, prematurity, etc.) 

How does the HUGS program help a family?

A health care professional is assigned to each family. These services are provided at no cost to the families. The care coordinator encourages a healthy pregnancy to promote positive birth outcomes. Families are assisted in accessing health care and other social and educational services. Attention is placed on enhancing family strengths. Education is provided regarding pregnancy, growth, development, and parenting education. Emphasis is placed on SIDS counseling and ways to decrease the risk of SIDS.

Who can I contact if I am interested in the program or to make a referral to HUGS?

Linda Busby, RN

HUGS Supervisor

Phone: 901-222-9703

Fax:  901-222-7976

Email- linda.busby@shelbycountytn.gov