[Congressional Record (Bound Edition), Volume 157 (2011), Part 13]
[Senate]
[Pages 18400-18401]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      PREMATURITY AWARENESS MONTH

  Mr. BROWN of Ohio. Mr. President, November is Prematurity Awareness 
Month, but as the month comes to an end, our fight against preterm 
births and complications caused by prematurity continues daily in 
hospitals, homes, and research facilities across the country.
  Each year in the United States, more than half a million babies are 
born prematurely. More startling, over the last 25 years, the rate of 
preterm birth has increased more than 36 percent. Today, prematurity is 
the leading cause of newborn death in the United States.
  Additionally, a preterm baby is four times more likely to have at 
least one medical condition, such as cerebral palsy and learning and 
behavioral problems. And the life-long health complications caused by 
pre-term birth also have a serious financial burden on the child and 
parent. A premature birth costs, on average, $51,000 in the first year 
alone; premature births cost our nation $26 billion annually. Yet, 
despite the costs in lives lost and families burdened, medical research 
and innovation continues find new cures and therapies.
  On the Federal level, beginning in 2003, the National Institutes of 
Health (NIH) invested approximately $21 million in research for a 
drug--progesterone or 17P--to prevent preterm birth. 17P was found to 
reduce preterm births by 37 percent in high-risk pregnancies, and 
compounding pharmacists were able to provide compounded 17P to women 
for a mere $10-$20 a dose. Earlier this year, however, a pharmaceutical 
company received exclusive rights to manufacture the drug and increased 
the price by 14,900 percent to $1,500 a dose. But because of the 
advocacy of Ohio's leading children's hospitals from Cleveland to 
Cincinnati--because of the stories of pregnant women I met in airports 
and community halls, we raised the public's awareness to the 
astronomical price gauge and increased public demand against the 
company to reconsider its pricing. The company eventually reduced the 
cost of its branded version of 17P, Makena, from $1,500 a dose to 
$690--still significantly more expensive than the compounded version. 
Given the public and Congressional outcry and the importance of the 
medication to pregnant women and their babies, the Food and Drug 
Administration (FDA) announced that compounding pharmacies would still 
able to offer women the more affordable version of 17P. Our work 
continues to make such a life-saving drug more affordable and available 
to millions of women who depend on it.
  But despite the success of 17P in preventing preterm births, more 
needs to be done. Every year March of Dimes grades each state on their 
rates of premature birth. While Ohio is improving, the current 12.3 
percent premature birth rate--or 500,000 children annually--leaves Ohio 
with a C grade. Fortunately, hospitals, patients groups, and public-
private partnerships are working to reduce preterm births in Ohio.
  In 2009, central Ohio's four hospital systems--Nationwide Children's 
Hospital, The Ohio State University Medical Center, OhioHealth, and 
Mount Carmel Health System--as well as the Columbus Public Health 
Department, Franklin County's Board of Commissioners, and non-profit 
groups came together through Ohio Better Birth Outcomes (OBBO) to 
reduce the number of preterm births in Franklin County. OBBO's efforts 
include home nurse visits to low-income mothers from the 28th week of 
gestation through the child's second birthday and education and 
counseling for mothers about ``safe spacing'' of pregnancies. By 
allowing their bodies at least 18 months to fully heal between 
pregnancies, their subsequent pregnancies will be healthier. Through 
this work, OBBO was able to increase gestation time by an average of 
six weeks and two days. For each week a woman is able to carry her baby 
between 36 weeks and 39 weeks, the baby has a 23 percent decrease in 
respiratory diseases, seizures, brain hemorrhages, and other 
complications.
  Ohio is also home to the Ohio Perinatal Quality Collaborative, which 
consists of 45 clinical teams from 25 Ohio hospitals. The 
Collaborative, based at Cinncinati Children's Hospital Medical Center, 
includes all of Ohio's children's hospitals as well as regional 
hospitals such as Akron's Summa Health System, the Toledo Hospital, the 
Mount Carmel Hospital System, St. Elizabeth's Health Center in 
Youngstown, and Miami Valley Hospital in Dayton. Twenty-four teams are 
focusing on reducing catheter associated infections in preterm babies 
and the other 21 teams are focusing on reducing the number of 
deliveries that occur between 29 and 36 weeks gestation.
  In my hometown of Mansfield in Richland County, Ohio, the Community 
Health Access Project (CHAP) stepped in after discovering that certain 
groups of women were three times more likely to give birth to a low 
birth weight infant. Through a series of community outreach 
initiatives, CHAP community health workers and local volunteers were 
able to identify and break down barriers, such as transportation needs 
and cultural differences, to better address the health needs of at-risk 
pregnant women. In its first

[[Page 18401]]

three years, the number of low birth weight babies in the region showed 
a decline from 22.7 percent to 8 percent and CHAP has become a national 
model in community health services.
  At University Hospitals (UH) in Cleveland, the MacDonald Women's 
Hospital and Rainbow Babies & Children's Hospital implemented a 
Centering Pregnancy Program in 2010. This unique, group-based program 
targets socially at-risk women who are least likely to receive 
consistent prenatal care and have the greatest risk of having a low 
birth weight baby or delivering prematurely. The program has enabled UH 
to dramatically reduce incidences of preterm births and low birth 
weight babies by 8 percent and 8.7 percent below the national average 
respectively.
  November has come to an end, but I look forward to continue working 
with organizations and health systems in Ohio and across the country to 
reduce premature births and ensure a healthy start in life for our 
Nation's children.

                          ____________________