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Writer's picturePaediatrics & Fetal Team

Premature Birth and Preterm Babies

By: Shania S.


What is premature birth? Premature or preterm birth is when a baby is born too early, specifically before 37 weeks of pregnancy have been completed. About 15 million babies worldwide (more than 1 in 10 babies born every year) are born too early every year.


Complications/Consequences of Premature Birth

  • Short-term:

    • Breathing problems

      • A premature baby may have trouble breathing due to an immature and underdeveloped respiratory system.

    • Lung disorder

      • Premature babies may develop a lung disorder known as bronchopulmonary dysplasia.

    • Heart complications

      • The most common heart problems in premature babies are low blood pressure (hypotension) and patent ductus arteriosus (PDA).

    • Brain problems

      • The earlier a baby is born, the greater the risk of bleeding in the brain, which is known as intraventricular hemorrhage.

    • Lack of temperature control

      • Premature babies can lose body heat rapidly and if body temperature drops significantly, hypothermia can occur. Hypothermia in a premature baby can lead to breathing problems and low blood sugar.

    • Gastrointestinal problems

      • Premature infants are more likely to have immature gastrointestinal systems, resulting in further problems such as necrotizing enterocolitis (NEC).

    • Blood problems

      • Anemia and newborn jaundice can occur in premature babies. Newborn jaundice is a yellow discoloration in the skin and eyes that occurs because the blood contains an excess amount of bilirubin.

    • Dysfunctional Metabolism

      • Some premature babies may contain an abnormally low level of blood sugar, known as hypoglycemia. Premature babies may also have difficulty converting stored glucose into more usable forms of glucose.

    • Underdeveloped immune system

      • An underdeveloped immune system can lead to infections. Infections in a premature baby can then spread to the bloodstream, causing sepsis.


  • Long-term:

    • Cerebral palsy

    • Impaired learning

    • Vision problems and hearing problems

    • Dental complications

    • Behavioral and psychological problems

    • Chronic health issues such as asthma, infections, and feeding problems. Premature babies are also at a higher risk of sudden infant death syndrome (SIDS).


Advances in Treatment and AID

Health outcomes and survival for premature babies have been steadily improving over the years. A 20 year study of the core care practices, morbidity, and mortality of preterm babies found that over the study period, “survival without major complications” for babies born at 28 week increased from 43 percent to 59 percent (Keeffe, 2017). These improvements can be largely attributed to improved treatment techniques and care practices for these preterm babies.


Modern treatments and care include:

  • Supportive care

    • Use of incubators

      • Premature babies are placed in incubators that are kept warm in order to prevent hypothermia and help babies maintain a healthy body temperature.

    • Monitoring of vital signs

      • These include blood pressure, heart rate, breathing and temperature.

    • Feeding tube

      • Having an intravenous feeding tube to help the baby receive necessary nutrients and fluids.

    • Use of bilirubin lights

      • Preterm babies may be placed under bilirubin lights to treat newborn jaundice by helping them break down excess bilirubin.

    • Blood transfusions

      • Blood transfusions will be used if blood volumes need to be raised.


  • Medications:

    • Surfactant

      • Used to treat respiratory distress syndrome

    • Fine-mist

      • Used to enhance breathing and heart rate

    • Antibiotics

      • Used to treat infections

    • Medications that increase urine output in order to manage excess fluids

    • An injection of medications into the eye in order to prevent the growth of new blood vessels that may cause retinopathy of prematurity (an eye disorder common in preterm newborns)


  • Surgery

    • Surgery may also be necessary to treat certain complications as a result of preterm birth


  • Taking premature babies home

    • A premature baby is only allowed to be taken home in the care of their parents/legal guardians when the baby:

      • Can breathe without support

      • Can maintain a stable body temperature

      • Can breast- or bottle-feed

      • Is gaining weight steadily

      • Is free of infection

 

References:


Keeffe, P. (2017, September 28). How Modern Medicine is Saving the LIves of Premature Babies. Healthline. Retrieved January 19, 2022, from https://www.healthline.com/health-news/how-modern-medicine-is-saving-the-lives-of-premature-babies-101415#1


Mayo Clinic. (2021, April 14). Premature Birth. Mayo Clinic. Retrieved January 19, 2022, from https://www.mayoclinic.org/diseases-conditions/premature-birth/diagnosis-treatment/drc-20376736


World Health Organization. (2018, February 19). Preterm Birth. World Health Organization. Retrieved January 19, 2022, from https://www.who.int/news-room/fact-sheets/detail/pretermbirth#:~:text=Preterm%20is%20defined%20as%20babies,preterm%20(28%20to%2032%20weeks)

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