What is Prematurity
- Every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising.
- Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 1 million deaths in 2015 (1).
- Three-quarters of these deaths could be prevented with current, cost-effective interventions.
- Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born.
Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, based on gestational age:
- extremely preterm (less than 28 weeks)
- very preterm (28 to 32 weeks)
- moderate to late preterm (32 to 37 weeks).
Induction or cesarean birth should not be planned before 39 completed weeks unless medically indicated.
Who is at risk for prematurity?
Many women have no known risk factors for premature birth. But several things can make premature birth more likely.
Women with these risk factors are more likely to deliver early:
- Having had a past preterm labor or birth.
- Getting pregnant within a short time (less than a year) after having had a baby.
- Being pregnant with more than one baby.
- Having an abnormal cervix or uterus " Being younger than 16 or older than 35
- Having health problems such as high blood pressure, diabetes, heart disease, or kidney disease or high levels of social and psychological stress.
- Smoking
In addition, women who develop any of the following problems during pregnancy are more likely to deliver early-
- Infections
- High blood pressure
- Diabetes
- Blood-clotting problems
- Problems with the placenta
- Vaginal bleeding
How is prematurity treated?
Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment may include:
- Corticosteroid medicine is given to the mother before a premature birth to help the baby's lungs and other organs grow and mature.
- Watching the baby's temperature, blood pressure, heart and breathing rates, and oxygen levels.
- Temperature-controlled bed or incubator.
- Oxygen is given by mask or with a breathing machine called a ventilator.
- IV (intravenous) fluids, feedings, or medicines.
- Special feedings with a tube in the stomach if a baby can't suck.
- X-rays or other imaging tests.
- Skin-to-skin contact with the parents (kangaroo care).
What are the possible complications of prematurity?
Premature babies are cared for by a Neonatologist. This is a doctor with special training to care for newborns. Other specialists may also care for babies, depending on their health problems.
Premature babies are born before their bodies and organ systems have fully matured. These babies are smaller than they would have been if they were born at full term. They may need help breathing, eating, fighting infection, and staying warm. Extremely premature babies, those born before 28 weeks, are at the greatest risk for problems. Their organs and body systems are not ready for life on their own outside the mother's uterus. And they may be too immature to function well even with intensive care support.
Some of the problems premature babies may have include:
- Keeping their body temperature steady or staying warm.
- Breathing problems, including serious short- and long-term problems.
- Blood pressure problems due to immaturity of various organ systems (especially low blood pressure in early hours and days).
- Blood problems These include Jow red blood.
- Blood problems. These include low red blood cell counts (anemia), yellow color to the skin from breaking down red blood cells (jaundice).
- Kidney problems due to immaturity.
- Digestive problems, including immature absorption and digestion. Most premature babies need intravenous IV nutrition for some time at birth. In some cases, there may be inflammation and death of parts of the intestine (necrotizing enterocolitis). Babies are often not able to feed by mouth until closer to their due date and will need tube feedings. The best feeding is mom's own milk. If this isn't possible, donor human milk from a milk bank is the safest alternative.
- Nervous system problems, including bleeding in the brain or seizures.
- Infections.
Premature babies can have long-term health problems as well. Generally, the more premature the baby, the more serious and long-lasting the health problems may be.
Can prematurity be prevented?
More babies are surviving even though they are born early and are very small. But it is best to prevent preterm labor if possible.
It's important to get good prenatal care while you are pregnant. Your healthcare provider can help find problems and suggest lifestyle changes to lower the risk for preterm labor and birth. Some ways to help prevent prematurity include:
- Stop smoking if you smoke. You should stop smoking before you are pregnant.
- Finding out if you are at risk for preterm labor.
- Learning the symptoms of preterm labor.
- Getting treated for preterm labor
Your healthcare provider may give you the hormone progesterone if you are at high risk for preterm birth. Progesterone can help if you have had a past preterm birth.
