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H. R. No. 535 As IntroducedAs Introduced
| 130th General Assembly | | Regular Session | | 2013-2014 |
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Representatives Gonzales, Antonio
A RESOLUTION | To declare Ohio's rate of infant mortality a public
health crisis and urge comprehensive preterm birth
risk screening for all pregnant women in Ohio.
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BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF OHIO:
| WHEREAS, Ohio is ranked among the worst in the nation in
infant mortality (47th), with the loss in 2012 alone of 1,047 Ohio
babies before their first birthdays; and |
| WHEREAS, The leading cause of infant mortality is preterm
birth. In Ohio, the preterm birth rate is 12.1% (16,732 Ohio
babies born too soon in 2012) and about half of all
pregnancy-related costs are driven by preterm births, largely
because of expensive care of infants in neonatal intensive care
units (NICUs). Among babies born before 32 weeks gestation, 89%
are admitted to NICUs at an average cost of $280,000; and |
| WHEREAS, Socioeconomics, education, geography, and other
factors contribute to health access barriers for many Ohio women
and a lack of prenatal care increases the risk of preterm birth
and infant mortality; and |
| WHEREAS, Medicaid pays for 38% of Ohio's pregnancies (about
53,000 annually). In Ohio, NICU babies account for only 0.2% of
the Medicaid population but consume 15% of total Medicaid
spending; and |
| WHEREAS, Cervical length is the best predictor of preterm
birth risk. Women with a prematurely short cervix mid-pregnancy
are at 10 times the risk of an early delivery, which can have
tragic consequences; and |
| WHEREAS, Two technologies that accurately measure the cervix
are available: transvaginal ultrasound and use of a cervicometer.
Using these technologies, cervical length screening could be
performed in any prenatal care setting for pregnant women in Ohio
and treatment provided to prevent preterm births and infant
deaths; and |
| WHEREAS, The Society for Maternal-Fetal Medicine and the
American College of Obstetricians and Gynecologists have published
clinical practice guidelines recommending vaginal progesterone
treatment to prevent preterm birth in women pregnant with one baby
and a mid-pregnancy short cervical length. In this high risk
population, treatment cuts the rates of preterm birth and infant
mortality nearly in half while reducing NICU admissions by 25%;
and |
| WHEREAS, Economic analyses of universal cervical length
screening and vaginal progesterone treatment prove that this
preterm birth prevention strategy is cost-saving. The drug used in
this treatment is available in generic form; a full course of
treatment costs less than $400. Adoption of this strategy across
Ohio could result in savings over $27 million annually, with over
$10 million of that total in Medicaid savings; and |
| WHEREAS, The Ohio Collaborative to Prevent Infant Mortality
of the Ohio Department of Health, the Ohio Perinatal Quality
Collaborative, and many other state and local organizations have
been working diligently to raise awareness and promote the
adoption of best practices, including appropriate use of
progesterone to prevent preterm birth. Among the top priorities of
the Ohio Department of Medicaid is more timely identification of
high risk expectant mothers to provide enhanced services, such as
ensuring "progesterone without barriers" for Ohio pregnant women;
and |
| WHEREAS, The good health and well-being of Ohio's expectant
mothers and their babies will be enhanced by education on the
importance of cervical length measurement as an evidence-based,
cost-saving prenatal risk screening test. Beneficiaries of such
education should include health care professionals, women and
families, Medicaid and private health insurers, government
officials, elected officials, and all others who share the mission
of reducing preterm birth and infant mortality; now therefore be
it |
| RESOLVED, That we, the members of the 130th General Assembly
of the State of Ohio, support and encourage improved education and
outreach concerning prenatal care, cervical length measurement,
and progesterone treatment; and be it further |
| RESOLVED, That we declare Ohio's rate of infant mortality a
public health crisis that deserves significant and immediate
action by all stakeholders to ensure equitable access to
comprehensive preterm birth risk screening for all pregnant women,
including cervical length screening; and be it further |
| RESOLVED, That the Clerk of the House of Representatives
transmit duly authenticated copies of this resolution to the
Governor of Ohio and the news media of Ohio. |
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