Prematurity is the most common cause of sickness and death among newborns. Babies born before the 37th week of pregnancy are often called preterm or “premature”, babies born before the 32nd week are considered very premature, babies born before the 28th week are considered extremely premature. Generally, babies born after the 25th week of pregnancy have a survival rate of between 50-60% (although they will stay an extended period of time in intensive care), which increases dramatically to over 90% after the 28th week.
Babies born earlier at the 22nd week of pregnancy have less than a 2% chance of survival, while babies born before the 20th week are said to be miscarried and cannot survive outside the womb, even with our improved medical technology. The more mature babies are at birth, the more likely they are to survive and the less likely they are to have health problems. In addition to age, the baby’s size tends to influence how well he or she does; larger babies generally do better.
Many times, babies born preterm face weeks and sometimes even months in the neonatal intensive care unit (NICU), depending on their gestational age, size and overall medical condition. Usually, premature babies are too sick and too small to go home until close to their original estimated due date.
Preterm Health Problems
Preterm babies are at risk for a variety of health problems, serious complications and even death. Some have lasting disabilities (depending on their degree of prematurity) such as cerebral palsy, mental retardation, reading and learning problems (or developmental delay), chronic lung disease and blindness or deafness.
Other babies, usually those born closer to term, have no long-term problems and grow up completely healthy. Sometimes, babies born closer to term (34-36 weeks) still have certain complications, as well as suffer 2-3 times the infant mortality rate during the first year as full-term babies. Mortality rates during the first year for babies 32-33 weeks are 6 times higher than those born full-term.
Preterm Labor Treatment
Babies born before 34 weeks often need to be on a ventilator (and may need a medication called surfactant) to help them breathe, because of respiratory problems. A common condition for these preterm babies is called respiratory distress syndrome (or hyaline membrane disease), which is a serious breathing problem caused by immature lungs, making it difficult or impossible for their air sacs to stay open, due to the lack of surfactant in the lungs.
Apnea is also common, especially in babies born before 30 weeks. Apnea causes babies to stop breathing for short periods of time, due to their immature respiratory and nervous systems. Intraventricular hemorrhage (IVH) sometimes happens in the first few days of life and is quite common in very premature babies. This condition is when bleeding in the brain occurs, which can potentially cause seizures and brain damage.
Certain blood and metabolic problems may occur in babies born before term. Anemia (low blood counts), which may require a blood transfusion is not uncommon.
Early babies may develop jaundice, due to their livers being too immature to normally process bilirubin, which may turn them yellow or orange in color. Cardiovascular conditions may occur, such as patent ductus arteriosus (PDA), which is a heart condition that causes blood to divert away from the lungs. With this, a blood vessel near the heart (that normally closes after delivery) stays open and may need to be closed with surgery, if medication doesn’t work.
Feeding difficulties are common for preterm babies, since many are unable to suck, due to undeveloped suck and swallow reflexes. Often, they require tube feedings, in which a tube is placed in the mouth or nose that goes down into the stomach. You can still pump your breast milk for your baby, which is ideally the best for your tiny little one. Preterm babies typically are cared for under special heaters or in enclosed incubators that help maintain a stable body temperature, due to temperature instability from low body fat and thin skin.
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