The appearance of the baby causes many questions for parents. And it is not surprising that the parents of a premature baby have many times more questions, as well as worries, especially if the newborn has to spend many weeks in the hospital before leaving for home. This article will address the most common questions of parents having a premature baby.
When is a Baby Considered Premature?
A full pregnancy lasts about 40 weeks from the first day of the last menstrual cycle. If a child is born at 38-42 weeks, then it is considered full-term.
Definitions vary slightly among medical experts and organizations, but usually, when a baby is born before 37 weeks, it is considered premature.
The calculation is made on the basis of the following data: the time since the last menstrual cycle of the mother, the assessment of the physical and neurological maturity of the child using ultrasound measurements in the womb, as well as direct examination after birth.
How Often do Preterm Labor Occur?
After decades of growth, the number of preterm births has decreased in the past few years. Today, about 1 in 10 children is born before the 37th week of pregnancy.
What is Known about the Survival Rate of Premature Babies?
Every day, science and medicine are getting more and more data on preterm labor. That is why fragile premature babies today have a better chance of nursing than 10 years ago. Today, however, is impossible to tell the minimum time spent in the womb, sufficient for survival, because each child is unique. Doctors who observe your pregnancy and specialists of the intensive care units for newborns will give you all the advice you need in this case. At present, with a period of 25 weeks and a fetus weight of 480 grams, the baby is considered viable.
What Causes Preterm Labor?
There are many factors that can trigger preterm labor, some are known, and some have not yet been identified. Known risk factors account for about half of preterm births. Such risk factors include:
Urinary tract infections, respiratory diseases, and vaginal infections are known to be associated with preterm labor. Recently, gum diseases and other undetected viral diseases are considered to be additional factors of premature birth. Even if the infection was not detected at the time of premature birth, changes in the placenta may indicate past diseases.
Group B streptococcus bacteria are also associated with preterm birth, even without the occurrence of any diseases in the mother. That is why there is a test for this infection, isolating group B streptococcus bacteria for their subsequent analysis or rapid screening of a smear of the female vaginal and rectal area to detect infection. If an infection is detected, it must be treated with antibiotics before or during labor to prevent the infection from spreading to the infant. At the onset of preterm birth, the infection is considered a risk factor, so after birth, mother and child are treated with antibiotics.
The membranes surrounding the baby in the womb are the main barrier to infection. If they are damaged or torn earlier, the infant is at risk of infection. This is called premature membrane rupture. If any sign of infection is detected in the mother or fetus during monitoring, this is a possible threat of premature birth. Premature rupture of the membranes can be caused by infection.
Mothers carrying twins, triplets, or more babies at the same time rarely give birth on time. Twins have an estimated 25–50% chance of being born prematurely, and the likelihood increases in proportion to the number of babies being born. At the same time, the uterus may become dense and begin to contract, the placental blood flow may decrease, or the placenta may deteriorate. Any of these causes in multiple pregnancies can provoke preterm birth or force doctors to decide on the induction of labor.
Infants with developmental disabilities may be born prematurely. Ultrasound imaging often helps to detect such anomalies. If the child needs medical intervention before the deadline, doctors may decide to stimulate preterm labor or perform an intrauterine operation (microsurgical intervention).
Pregnant women with pathological abnormalities of the uterus or cervix of the uterus, chronic diseases such as kidney disease, preeclampsia/eclampsia (a disease in pregnancy associated with high blood pressure), diabetes mellitus, dysfunction, bleeding, or damage to the placenta, usually need early childbirth. In this case, according to the indications, and depending on the severity of the condition, childbirth can be carried out by cesarean section or artificially caused by natural means (induced birth) for the welfare of the mother and/or child.
There are also other factors in the health of the mother that is capable of provoking preterm birth with an even higher probability. These include:
- Preterm labor in the past.
- Fertility problems, second trimester abortion or miscarriage.
- Pregnancy six weeks or less after a previous birth.
- Lack of weight at conception or insufficient weight gain (less than 9 kg) by asthenic women during pregnancy.
- Age – younger than 17 years old or over 35 years old.
- Work on the last stages of pregnancy, heavy physical exertion or exposure to strong emotional stress.
- Smoking, drug and alcohol use.
How to Reduce the Likelihood of Preterm Birth?
It is impossible to prevent premature delivery, but there are some things you can do to reduce the risk of premature birth. Good prenatal care and good health care before and during pregnancy, as well as parental awareness, can really help. Proper laboratory and clinical diagnosis will help identify and cure any infections in advance.
If you have a pregnancy with a high risk of complications or a chronic or acute illness, contact your observatory gynecologist as soon as possible. Good nutrition, a corresponding increase in weight, exclusion of smoking, or the use of alcohol, drugs, can also reduce the likelihood of premature birth.
What is Extremely Premature Birth?
Not all premature babies fall into one category. This is due to the fact that the number of estimated weeks that the child did not spend in the womb affects his health, the degree of maturity and the functioning of organs and systems, and the type and amount of medical care necessary to ensure that the baby develops. Many experts identify three main categories of premature birth: late preterm, very preterm, and extremely preterm.
Infants born before 25–28 weeks of gestation are considered extremely or critically premature. The main organs of a child born so early are not yet fully formed. Specialized staff of the neonatal intensive care unit will be able to help you decide on treatment and other measures to provide support to your child.
What is very Preterm Birth?
If a baby is born before the 32nd week of pregnancy and has characteristic clinical signs (lethargy, disproportionate development, underdevelopment of organs and systems), he/she is considered to be a very premature baby. The survival rate of babies in this category is much higher than that of those that are born extremely premature, but they will still face health problems that can be overcome by neonatology intensive care physicians. These highly qualified doctors will also be able to offer you the best treatment and care options because in many cases, health problems can be long-term.
What is Late Prematurity?
A child born between 32 and 37 weeks of gestation is classified as late preterm. Such infants can be pretty much like full-term babies, only slightly smaller. They may still encounter problems, such as breathing troubles, difficulties with feeding, and thermoregulation. Doctors will be able to give you advice on how to reduce any risk of complications so that you can take your newborn home as soon as possible.
What to Expect During a Hospital Stay?
Premature babies and babies with developing complications should stay for some time at the perinatal center or specialized hospitals with a newborn resuscitation department, where they will receive the necessary assistance. When the state of health stabilizes, the baby is usually transferred to the department for newborns and premature babies so that the baby continues to grow and develop there until he/she is ready to go home.
You may be confused by some unfamiliar terms used by hospital staff. Depending on the situation, your child may need different specialized tests. You can also meet different types of equipment specifically designed for premature babies. This can help you explore this issue, familiarize yourself with these types of procedures and equipment, which will help you feel a little more confident. Of course, the staff of the neonatal intensive care unit will always help you overcome the difficulties of the special situation of your child. Ask them to use “simple language” if you feel that they do not understand anything.
Each mother is worried about starting to breastfeed in time. However, if you have a premature baby, the situation with breastfeeding may differ slightly. The staff of the intensive care unit for premature babies is highly qualified medical specialists who can provide you with the best individual guidance on expressing breast milk, and much more.
You may be surprised by the little things that become especially important if you are the parent of a premature baby. For example, which clothes and diapers are better to wear? Do not be afraid to ask the staff of the intensive care unit all of your questions no matter how insignificant they may seem. Take the time to get all the answers you need. The doctors will gladly help you.
Will my Next Baby be Premature?
It depends on why preterm labor happened for the first time. If there are no specific risk factors observed other than the medical history, the date of birth of your next child will probably be close to the established one. However, if you have a pathology of the uterus or chronic diseases such as diabetes or kidney disease, it is highly likely that your next birth will also be premature. In addition, women over 35 years of age are at risk.
Born in Belarus, 1985, a pedagogue and family psychologist, mother. Taking part in procedures of social adaptation of the foster children in new families. Since 2015 is a chief editor of the motherhow.com project, selecting the best and up-to-date material for those, who are planning, expecting, and already having babies.