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http://www.nytimes.com/2003/02/06/health/06CND-BIRTH.html?tntemail0

Doctors Find Treatment to Reduce Risk of Premature Birth

By DENISE GRADY

octors reported today that they had found the first treatment ever proved to reduce the risk of premature birth in women with a high risk of having their babies too early.

"This is the first real success we've had in dealing with the biggest problem in obstetrics, which is preterm birth," said Dr. Paul Meis, who led a study of the treatment in 463 women at 19 medical centers around the United States.The study was sponsored by the National Institute of Child Health and Human Development.

Prematurity is an enormous problem in the United States, with nearly half a million babies a year born prematurely, about 12 percent of all live births. Many premature infants are born desperately ill, with lung problems and other disorders, and later develop other severe problems like cerebral palsy, mental retardation, hearing loss and blindness. Prematurity is also the leading cause of death within the first month of life in the United States.

The average hospital stay for a premature baby in 2000 cost $58,000, compared with $4,300 for a typical newborn.

The rate of premature births has risen 27 percent since 1981, according to the March of Dimes. The reason is not known. Among black women, the rate is 1.5 times that of whites, and doctors do not know why.

The new treatment, weekly shots of a hormone called 17-alpha-hydroxyprogesterone caproate, or 17P, reduced the rate of premature birth by more than a third in women who were at high risk because they had histories of giving birth early. The injections were started at 16 to 18 weeks of pregnancy and stopped at 36 weeks.

Dr. Meis, a professor of obstetrics and gynecology at Wake Forest University in Winston-Salem, N.C., said that 17P was an approved drug already on the market to treat other conditions, and that obstetricians who specialize in high-risk pregnancies would be able to obtain it to treat their patients.

A normal pregnancy lasts 40 weeks, but infants are not considered premature unless they are born before 37 weeks.

"We are thrilled," said Dr. Nancy Green, medical director of the March of Dimes, which was not involved in the study. "The problem has been getting worse, not better. Very little progress has been made in prevention. That's the excitement of this finding. We may be at the threshold of discovery of a new and effective means of prevention. If this finding holds up, it will really be a breakthrough in the treatment of the very women for whom treatment is most needed."

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