Health & Medicine

Potential treatment may help preemies avoid lung condition

Premature birth, also called pre-term birth, is a major problem in the state, but a University of Kentucky study shows promise in treating lung disease that is often associated with early delivery.

Nearly one out of every seven babies born in this state is premature. Kentucky's rate of pre-term birth — any baby born before 37 weeks — is 14 percent. The national rate is 12.5 percent.

Future moms can decrease their chances of delivering a baby early by getting good care before conception and getting early prenatal care. Smokers are encouraged to quit. Women who have a history of delivering early can try progesterone therapy to avoid another pre-term birth.

So why is being born early such a problem? While not all pre-term infants have health problems, many do, and at a much higher rate than babies born full term.

As a neonatologist at UK, I care for very premature infants. Because these babies have underdeveloped lungs, they're much more likely to have difficulty breathing or to develop lung infections. One of the major problems these babies face is a lung condition called bronchopulmonary dysplasia, or BPD.

Lung immaturity, which frequently progresses into BPD, is the leading cause of death among premature infants. BPD is characterized by inflammation and scarring in the lungs. Even babies who survive BPD face a greater chance of developing recurrent respiratory infections, such as pneumonia or bronchiolitis. Almost 50 percent are readmitted to the hospital during the first year after discharge from the neonatal intensive care unit.

Treatment options for preventing BPD are few. However, a study done at UK showed results that may be promising for treating certain infants at risk for developing BPD.

The study was performed on 220 pre-term infants admitted to the UK intensive care unit from 2004 to 2008. All weighed less than two pounds, 12 ounces. All were on mechanical ventilation to help with their lung immaturity.

For six weeks, the infants received either a weight-appropriate dose of azithromycin — the same antibiotic you take in a Z-Pak — or a placebo.

Upon completion of the study, we noticed a significant trend. Babies who received the antibiotic and who were already infected or colonized with Ureaplasma bacteria were 21 percent less likely to develop BPD.

Presence of the Ureaplasma bacterium is a big risk factor for developing BPD. An estimated 80 percent of women have this bacterium in their system, and it is easily passed on from mother to child. For pre-term babies, who often have weaker immune systems than their full-term counterparts, the inflammation from this bacterial infection often leads to full-fledged BPD.

More research is needed to study azithromycin therapy for the routine treatment of premature infants who have Ureaplasma in their system. But we believe that with early identification and treatment of these babies, we can really lower their chance of developing bronchopulmonary dysplasia.

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