Also called premature birth, a preterm birth is when a baby is delivered three weeks prior to due date or before 37 weeks of pregnancy; normal pregnancy period is 40 weeks. The resulting baby is called a premature baby. Premature babies are underdeveloped and susceptible to multiple medical complications.
Most preterm births are spontaneous; however, there are some preplanned cases. In fact, close to 25 percent of preterm births are planned. In other words, if the mother and baby exhibit serious medical complications, such as preeclampsia or lack of baby growth, the doctors may induce preterm labor or do a caesarean section prior to 37 weeks.
Premature births can be categorized as
- Late preterm (34-36 weeks)
- Moderate preterm (32-34 weeks)
- High preterm (before 32 weeks)
- Extreme preterm (before 25 weeks)
Most premature babies are born in the 34-to-37-week range.
Possible Causes or Risk Factors
At the moment, there aren’t any conclusive evidences to what cause premature babies. But the following or their combinations could be likely triggers.
- Fertility treatments are likely to lead to twins or more babies, who could arrive prematurely.
- Genital tract bacteria that may lead to uterus inflammation, triggering a series of events resulting in preterm labor.
- Sexually transmitted infections such as gonorrhea and chlamydia.
- Some non-uterine infections, such as pneumonia, kidney infection and appendicitis may increase preterm birth risks too.
- Issues with the placenta, such as placenta accreta, placenta praevia, or placental abruption.
- An extremely huge uterus, usually the scenario when there is multi-child pregnancy (such as twins or triplets) or excessive amniotic fluid.
- Structural cervix or uterus abnormalities.
- Previous preterm delivery (deliveries).
- Pregnant with twins or more.
- A 17-year-old or younger expecting mother, or pregnancy in an older woman (above 35 years of age).
- Underweight before pregnancy or the inability to gain sufficient weight during pregnancy.
- First trimester or second trimester vaginal bleeding. Multiple-trimester bleeding means increased risks.
- Mild or serious anemia during early pregnancy.
- Smoking, alcohol abuse or drug usage before or during pregnancy.
- Closely-spaced subsequent pregnancies, or a fresh pregnancy within six months of previous delivery.
- Lack of or late prenatal care.
- High stress levels, especially chronic stress, are also positively correlated to preterm birth. The stress can be associated with domestic violence, night shifts or physically demanding jobs, etc.
Premature Birth Implications
A preterm birth may lead to serious baby health conditions or even prove fatal (infant mortality), especially if the birth is too early. The following are the effects on the baby:
- Breathing issues.
- Increased risks of brain hemorrhage, heart problems, metabolism and immune system issues.
- Impaired gastrointestinal tract, nervous system, and other body organs.
- Increased infections and jaundice risks.
- Grown-up babies could suffer long-term complications such as hearing and vision impairment, chronic lung disease, cerebral palsy, intellectual disabilities, autism, dental issues, and growth and development issues.
Generally, the earlier the premature birth, the higher the medical complications.
Preterm Birth Detection Tests
A couple of screening tests: an ultrasound and cerclage are recommended to predict and/or address preterm delivery possibilities. An ultrasound helps check cervix length and any shape/size changes. If the cervix is thinning or opening up, a preterm birth is likely. If the cervix is altering in shape, the doctor may recommend the potential mother to stop smoking (if applicable), reduce physical work and activity, and avoid sex. Based on the scenario and gestational age of the baby, another ultrasound could be conducted in some weeks.
A cerclage is advised if the pregnancy is not more than 24 weeks and the cervix is changing without exhibiting any contractions. Cerclage is risky and its efficacy is often debated. Anyway, the doctor will determine the patient’s candidacy for the procedure.
Other tests such as blood tests, echocardiogram, and an eye exam may also be conducted.
Eating well, getting abundant rest, starting prenatal care early, regularly visiting the practitioner, quitting unhealthy living and eating habits, managing stress levels, etc. hugely contribute to a full-term and healthy pregnancy.
The earlier the detection of preterm labor signs, the more beneficial the treatment will be for the baby and mother.
Prematurely-Born Baby: Care and Treatment
Generally, preterm babies are best tended to in hospitals equipped with neonatal intensive care units (NICU). Supportive care for the baby could entail:
- Baby placement within an incubator.
- Constantly monitoring the infant’s vital signs: heart rate, blood pressure, body temperature and breathing.
- Feeding the baby nutrients and fluids via an intravenous tube. Bottle-feeding or breastfeeding can be resorted to once the baby can suck on its own.
- Placement under bilirubin lights (a set of lights) to treat jaundice.
- Blood transfusion since the baby is underdeveloped to make its own red blood cells.
- Giving medicines to improve baby maturing and stimulate its organs’ normal functions.
Premature babies are usually fit to go home from the hospital if the breathing, body temperature, and weight becomes normal. The baby would also no longer be susceptible to infections.
Not all premature babies require post-birth hospital care. Some could be healthy enough to head home immediately after birth.