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Cell Free DNA Prenatal Testing is Not Definitive

WASHINGTON, Dec. 18, 2014—Statistics in the United States remain staggering in regard to infant mortality.  According to the United Nations, the U.S. ranks 55th in the world. This ranking is behind nations like Cuba and Slovakia.  Each year, more than 26,000 infants die before their first birthday. A baby dies of preterm birth every 30 seconds in the world. Preterm birth is the leading cause of infant morbidity and mortality, affecting 11.5 percent of all births in the U.S.—which is also among the worst in the world.   Infant mortality disproportionately affects African Americans with a rate that is double that of Caucasians.

Research has proven that expanding preterm birth risk screening to include universal cervical length screening to identify more pregnant women who can benefit from evidence-based progesterone treatment can significantly reduce the nation’s preterm rate. This, in turn, would reduce the overall infant mortality rate.

Recently, physicians with the Society for Maternal-Fetal Medicine (high-risk pregnancy specialists), American Congress of Obstetricians and Gynecologists , and the American College of Nurse-Midwives  joined with the March of Dimes and representatives from Medicaid Health Plans of America and the Perinatal Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development convened on Capitol Hill to brief Congress on the issue.  They were also there to seek the support of the U.S. Dept. of Health & Human Services in driving the adoption of progesterone use—a vital strategy in saving the lives of tens of thousands of infants annually.

The U.S. Department of Health and Human Services has identified the reduction of infant mortality as well as preterm birth as priority policy areas. Both the Centers for Medicare and Medicaid Services and Health Resources and Services Administration have supported pilot programs to develop best practices for preterm birth and infant mortality prevention.   However, little or no attention has been paid to driving adoption of the progesterone strategies both in women with no prior preterm as well as those with prior preterm birth as recommended by SMFM, ACOG, and ACNM.

“A country ranked number one in GDP should not also be ranked 55th in infant mortality rate. The evidence is clear and we have all of the necessary tools,” explained Dr. Vincenzo Berghella, president of SMFM and director of the Maternal-Fetal Medicine Program, Obstetrics & Gynecology at Thomas Jefferson University in Philadelphia. “A change in practice and emphasis on universal screening for premature cervical shortening and appropriate progesterone treatment, as well as progesterone for all those with prior preterm birth, is fundamental to the health and well-being of U.S. mothers and babies. Moreover, in women with singleton gestations and a prior spontaneous preterm birth, who develop a short cervical length before 24 weeks despite progesterone therapy, a cerclage should be performed.”

In 2012, the SMFM, ACOG,, and the ACNM  published practice guidelines for preterm birth prevention. These guidelines emphasized that the use of progesterone treatment is proven to reduce the risk of early preterm births and of neonatal morbidity and mortality by at least 40-50 percent in women with singleton gestations, no prior preterm birth (90 percent of the population), who develop a short cervix on ultrasound screening.

Economic analyses show that universal cervical length screening and appropriate progesterone treatment for those diagnosed with premature cervical shortening is cost saving. The economic toll of preterm birth in the U.S. exceeds $26.2 billion annually. This strategy could save as much as $750 million annually. On-going medical and other costs for preemies continue to be much higher than full-term babies through the first seven years of life.  Because Medicaid pays for 45 percent of births in the U.S. and the Children’s Health Insurance Program covers many preemies, the economic impact on government spending is tremendous.

# # #

The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine.  The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed.  For more information visit www.smfm.org.

Society for Maternal-Fetal Medicine Joins with Other Organizations to Brief Congress on Need for Medical Protocols that will Save the Lives of Infants in the U.S. by Reducing Preterm Birth

WASHINGTON, Dec. 18, 2014—Statistics in the United States remain staggering in regard to infant mortality. According to the United Nations, the U.S. ranks 55th in the world. This ranking is behind nations like Cuba and Slovakia. Each year, more than 26,000 infants die before their first birthday. A baby dies of preterm birth every 30 seconds in the world. Preterm birth is the leading cause of infant morbidity and mortality, affecting 11.5 percent of all births in the U.S.—which is also among the worst in the world. Infant mortality disproportionately affects African Americans with a rate that is double that of Caucasians.

Research has proven that expanding preterm birth risk screening to include universal cervical length screening to identify more pregnant women who can benefit from evidence-based progesterone treatment can significantly reduce the nation’s preterm rate. This, in turn, would reduce the overall infant mortality rate.

Recently, physicians with the Society for Maternal-Fetal Medicine (high-risk pregnancy specialists), American Congress of Obstetricians and Gynecologists , and the American College of Nurse-Midwives joined with the March of Dimes and representatives from Medicaid Health Plans of America and the Perinatal Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development convened on Capitol Hill to brief Congress on the issue. They were also there to seek the support of the U.S. Dept. of Health & Human Services in driving the adoption of progesterone use—a vital strategy in saving the lives of tens of thousands of infants annually.

The U.S. Department of Health and Human Services has identified the reduction of infant mortality as well as preterm birth as priority policy areas. Both the Centers for Medicare and Medicaid Services and Health Resources and Services Administration have supported pilot programs to develop best practices for preterm birth and infant mortality prevention. However, little or no attention has been paid to driving adoption of the progesterone strategies both in women with no prior preterm as well as those with prior preterm birth as recommended by SMFM, ACOG, and ACNM.

“A country ranked number one in GDP should not also be ranked 55th in infant mortality rate. The evidence is clear and we have all of the necessary tools,” explained Dr. Vincenzo Berghella, president of SMFM and director of the Maternal-Fetal Medicine Program, Obstetrics & Gynecology at Thomas Jefferson University in Philadelphia. “A change in practice and emphasis on universal screening for premature cervical shortening and appropriate progesterone treatment, as well as progesterone for all those with prior preterm birth, is fundamental to the health and well-being of U.S. mothers and babies. Moreover, in women with singleton gestations and a prior spontaneous preterm birth, who develop a short cervical length before 24 weeks despite progesterone therapy, a cerclage should be performed.”

In 2012, the SMFM, ACOG,, and the ACNM published practice guidelines for preterm birth prevention. These guidelines emphasized that the use of progesterone treatment is proven to reduce the risk of early preterm births and of neonatal morbidity and mortality by at least 40-50 percent in women with singleton gestations, no prior preterm birth (90 percent of the population), who develop a short cervix on ultrasound screening.

Economic analyses show that universal cervical length screening and appropriate progesterone treatment for those diagnosed with premature cervical shortening is cost saving. The economic toll of preterm birth in the U.S. exceeds $26.2 billion annually. This strategy could save as much as $750 million annually. On-going medical and other costs for preemies continue to be much higher than full-term babies through the first seven years of life. Because Medicaid pays for 45 percent of births in the U.S. and the Children’s Health Insurance Program covers many preemies, the economic impact on government spending is tremendous.

# # #

 The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine.  The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed.  For more information visit www.smfm.org.

SMFM to host a Congressional Briefing on Preterm Birth Prevention in Washington, D.C. on December 11, 2014

On December 11th at 12 p.m. EST, the Society for Maternal Fetal Medicine (SMFM), American Congress of Obstetricians and Gynecologists (ACOG), and the American College of Nurse-Midwives (ACNM), in cooperation with the Congressional Caucus for Women’s Issues, are hosting a congressional briefing: “The Key to Reducing Infant Mortality: Reducing Preterm Birth.”  This briefing follows a joint letter to Secretary Burwell, Department of Health and Human Services, which calls for attention in the national infant mortality reduction plan to the 2012 publications of SMFM, ACOG, and ACNM which outline a new preterm birth prevention strategy.

Featured Speakers:

  • Dr. Vincenzo Berghella, President, Society for Maternal and Fetal Medicine
  • Dr. Roberto Romero, Chief, Perinatal Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
  • Dr. Siobhan Dolan, Medical Advisor to the March of Dimes
  • Jeff Myers, President and CEO, Medicaid Health Plans of America

If you would like to attend to briefing, please RSVP by Dec. 9 to Alex Fabian (202-621-7077 or afabian@G2Gconsulting.com).

For media inquiries, please contact Vicki Bendure (202-374-9259 or vicki@bendurepr.com).

Background:

With 24,000 infant deaths each year, the U.S. ranks 55th in the world for infant mortality. Nearly 70% of babies who die before their first birthday were born prematurely.  The U.S. preterm birth rate of 11.5% also ranks among the worst in the world.  The economic toll of preterm birth exceeds $26.2 billion annually, largely due to expensive Neonatal Intensive Care Unit (NICU) admissions.

In 2012, publications from SMFM, ACOG, and ACNM recommended expanding evidence based use progesterone intervention to two high risk populations.  Progesterone is proven to reduce the rates of preterm birth, infant morbidity, and infant mortality while also reducing NICU admissions in singleton pregnancies with either a prior spontaneous preterm birth or premature cervical shortening. Screening for obstetric history is current practice.  The addition of universal cervical length screening enables preventive treatment for all of the pregnant women, and their babies, who can benefit from progesterone.

Medicaid Health Plans of America Center for Best Practices recently released an Issue Brief addressing the impact of preterm birth on Medicaid. This publication includes guidance and resources for quality improvement initiatives to drive adoption of the professional society guidelines.  Medicaid pays for 48% of pregnancies; and, this population suffers a disproportionate share of preterm births and adverse outcomes.

Letter to HHS Sec Burwell on Preterm Birth Prevention Strategies

Click here for additional information. 

Issue Brief: Medicaid Health Plan Roles to Reduce Preterm Birth Risk

Click here for additional information. 

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