Perinatal Neonatal

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Premature Birth

A premature birth is a birth that takes place more than three weeks before the baby is due — in other words, after less than 37 weeks of pregnancy, which usually lasts about 40 weeks.

Premature birth gives the baby less time to develop in the womb. Premature babies, especially those born earliest, often have complicated medical problems.

Depending on how early a baby is born, he or she may be:

  • Late preterm, born between 34 and 37 weeks of pregnancy
  • Very preterm, born at less than 32 weeks of pregnancy
  • Extremely preterm, born at less than 25 weeks of pregnancy

Most premature births occur in the late preterm stage.

Risk Factors:

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, drinking alcohol or using illicit drugs
  • Poor nutrition
  • 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
  • Unusual shape of the uterus

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.

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 arteriosis) 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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