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MARCH OF DIMES

ARTICLE

 

Premaure Babies

A premature baby is one who is born too early, before 37 weeks. Premature babies may have more health problems and may need to stay in the hospital longer than babies born later. 

They also may have long-term health problems that can affect their whole lives. About 1 in 10 babies is born prematurely each year in the United States. 

The earlier in pregnancy a baby is born, the more likely he is to have health problems. Some premature babies have to spend time in a hospital’s neonatal intensive care unit (also called NICU). This is the part of a hospital that takes care of sick newborns. But thanks to advances in medical care, even babies born very prematurely are more likely to survive today than ever before.

 

What health problems can premature babies have after birth?

Health problems that may affect premature babies include:

• Apnea. This is a pause in breathing for 20 seconds or more. Premature babies sometimes have apnea. It may happen together with a slow heart rate.

• Respiratory distress syndrome (RDS). This is a breathing problem most common in babies born before 34 weeks of pregnancy. Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing.

• Intraventricular hemorrhage (IVH). This is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid.

• Patent ductus arteriosis (PDA). This is a heart problem that happens in the connection (called the ductus ateriosus) between two major blood vessels near the heart. If the ductus doesn’t close properly after birth, a baby can have breathing problems or heart failure. Heart failure is when the heart can’t pump enough blood.

• Necrotizing enterocolitis (NEC). This is a problem with a baby’s intestines. It can cause feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature birth.

• Retinopathy of prematurity (ROP). This is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss.

• Jaundice. This is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well.

• Anemia. This is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body.

• Bronchopulmonary dysplasia (BPD). This is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage.

• Infections. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and spinal cord. 

 

How can you best care for your premature baby?

Talk to your baby’s health care providers about any health conditions your baby has. He may be healthy enough to go home soon after birth, or he may need to stay in the NICU for special care. Your baby can probably go home from the hospital when he:

• Weighs at least 4 pounds

• Can keep warm on his own, without the help of an incubator. An incubator is an enclosed unit that helps premature babies stay warm.

• Can breastfeed or bottle-feed

• Gains weight steadily (1/2 to 1 ounce each day)

• Can breathe on his own 

 

Your baby may need special equipment, treatment or medicine after he leaves the hospital. Your baby’s provider and the staff at the hospital can help you with these things and teach you how to take care of your baby. They also can help you find parent support groups and other resources in your area that may be able to help you care for your baby.

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Risk factors

( By Mayo Clinic Staff )

Often, the specific cause of premature birth isn't clear. Many factors may increase the risk of premature birth, however, including:

• Having a previous premature birth

• Pregnancy with twins, triplets or other multiples

• An interval of less than six months between pregnancies

• Conceiving through in vitro fertilization

• Problems with the uterus, cervix or placenta

• Smoking cigarettes or using illicit drugs

• Poor nutrition

• Not gaining enough weight during pregnancy

• Some infections, particularly of the amniotic fluid and lower genital tract

• Some chronic conditions, such as high blood pressure and diabetes

• Being underweight or overweight before pregnancy

• Stressful life events, such as the death of a loved one or domestic violence

• Multiple miscarriages or abortions

• Physical injury or trauma

 

For unknown reasons, black women are more likely to experience premature birth than are women of other races. But premature birth can happen to anyone. In fact, many women who have a premature birth have no known risk factors.

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Prevention

( By Mayo Clinic Staff )

Although the exact cause of preterm birth is often unknown, there are some things that can be done to help women — especially those who have an increased risk — to reduce their risk of preterm birth, including:

• Progesterone supplements. Women who have a history of preterm birth, a short cervix or both factors may be able to reduce the risk of preterm birth with progesterone supplementation.

• Cervical cerclage. This is a surgical procedure that helps prevent premature birth in women pregnant with only one baby who have a history of premature birth or who have a short cervix or both.

  During this procedure, the cervix is stitched closed with strong sutures that may provide extra support to the uterus. The sutures are removed when it's time to deliver the baby. Ask your doctor if you need to avoid vigorous activity during the remainder of your pregnancy.

Although not as well-studied as progesterone supplements and cerclage, there's also some evidence that the following things may help reduce the risk of premature birth:

• Eat a healthy diet even before you get pregnant. Although it's no guarantee of a full-term pregnancy, eating a healthy diet containing several servings of protein-rich foods, fruits and whole grains before you get pregnant may reduce your risk of premature birth. But, a diet high in fat, sugar and processed foods, such as chips and white bread, before pregnancy has been linked to a higher risk of premature birth.

• Calcium supplements. Taking 1,000 milligrams (mg) or more of calcium daily may lower your risk of preeclampsia — a serious complication of pregnancy — and preterm birth, especially for women who normally consume low amounts of calcium in their diets.

• Daily low-dose aspirin. Beginning late in the first trimester, taking a low-dose aspirin — 60 to 80 mg — daily appears to help certain women reduce the risk of premature birth. Women who may benefit from low-dose aspirin therapy include those with a history of preterm birth or preeclampsia, as well as women with chronic high blood pressure.

• Cervical pessary. Women pregnant with just one baby who have a short cervix may reduce their risk of premature birth with a cervical pessary. A pessary is a silicone device that fits around the cervix and may help support the uterus.

• Reduce chemical exposure. Exposure to phthalates — chemicals used to manufacture many products such as plastic, canned foods, cosmetics, nail polish and hairspray — is associated with a higher risk of premature birth. It isn't yet known if reducing exposure to these products would reduce the risk of premature birth, but it's a good idea to limit your exposure whenever you can.            

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