University Hospital selected to join national initiative to help premature babies thrive and develop healthy lungs

May 04, 2016

February newborns to get handmade red caps while their parents take home infant CPR kits.

(SAN ANTONIO, TX May 4, 2016) With the rate of premature births in Bexar County alarmingly high, University Hospital and UT Medicine San Antonio are joining a March of Dimes project underway in five large states that looks to give those babies a better start in life.

The project hopes to improve the way that women at high risk for premature births are given antenatal corticosteroid treatment, or ACT — a proven way to improve lung development and overall outcomes in babies born before 39 weeks of pregnancy.

The project is part of the March of Dimes Big 5 State Prematurity Collaborative, named for the five states that make up 40 percent of all births in the United States —  California, Florida, Illinois, New York and Texas. A collection of hospitals in these states is working to reduce premature births and the complications that often accompany them. University Hospital is the only hospital in San Antonio taking part in the project.

“We’ve been selected as one of five hospitals in the state of Texas to participate in this major quality improvement initiative for the country,” said maternal-fetal medicine specialist Patrick Ramsey, MD, who practices at University Hospital and UT Medicine, and is a professor in the Department of Obstetrics and Gynecology at The University of Texas Health Science Center. UT Medicine is the medical practice of the School of Medicine.  “These efforts to improve utilization of antenatal corticosteroids will be very effective to help pregnant women have healthier babies.”

Giving steroid injections to high-risk pregnant women is a recommended practice already, with plenty of research showing its effectiveness in helping improve the outcomes for premature babies. It’s even something The Joint Commission — a national accrediting body for healthcare organizations — looks at when it reviews hospital performance, said Cheryl Bonecutter, DNP, director of the Perinatal/Neonatal Program at University Health System, and who serves on the Maternal and Child Health Impact Committee with the Texas Chapter of the March of Dimes.

“We give antenatal steroids to pregnant women in preterm labor to improve outcomes with these babies,” said Dr. Bonecutter. “The steroids can improve their lung function to the point they can do very well, many without any respiratory problems depending on the gestation.”

Steroids already are routinely given to high-risk women at University Hospital. But while ACT is a recommended practice, it isn’t given as consistently as it should across the country. The project will look at developing a best-practices bundle of steps that will quickly identify patients at high risk for preterm labor and help guide providers in treating them. 

The project will also look to educate doctors, nurses, transport teams and others about the best use of ACT.

San Antonio recently received a grade of F by the March of Dimes because of its high rate of premature births —11.5 percent in 2013, higher than any other major city in the state. Texas as a whole, with a rate of 10.3 percent, received a C.

San Antonio will be the site of a prematurity summit later this year, bringing together healthcare professionals, hospitals and community leaders to discuss a number of strategies aimed at lowering San Antonio’s high rate of premature births.  The use of antenatal corticosteroids and the impact of the March of Dimes ACT initiative will be one of many topics highlighted at the summit.

Dr. Ramsey and Dr. Bonecutter are co-directors of the March of Dimes ACT program at University Health System. “This initiative is an example of the exceptional collaborative efforts between academic partners of University Health System and The University of Texas Health Science Center at San Antonio to advocate and improve the care for pregnant women in San Antonio and throughout South Texas,” Dr. Ramsey said.