Preterm birth is a global problem. There are recorded cases in high, low, and middle-income countries. According to the World Health Organization (WHO) about 15 million babies are born preterm each year; that is more than 1 in 10 babies worldwide.
Preterm birth, also known as premature birth, is the birth of a baby before the start of the 37th week of pregnancy. Normally, a pregnancy lasts about 40 weeks. Babies born preterm (referred to as preemies or premmies) have less time to fully develop in the womb and are often prone to health complications.
Doctor Samuel Asala, Medifem Multi-specialist Hospital and Fertility Centre, noted that “if the number of weeks of pregnancy isn’t known, doctors assess the baby to determine whether or not it is preterm, but if the number of weeks is known, no assessment is required.” He added that although preterm children are more likely to have conditions like infection, low blood sugar, low body temperature, or have breathing problems, “doctors are able to cater well for them and help them to live healthy normal lives just as other children.”
Preterm birth occurs in varying phases. Depending on how early a baby is born, he or she may be described as: Late preterm, that is born between 34 and 36 weeks of pregnancy; Moderately preterm, born between 32 and 34 weeks of pregnancy; Very preterm, born at less than 32 weeks of pregnancy or Extremely preterm, born at or before 25 weeks of pregnancy.
What Causes preterm birth?
A lot of times, the specific cause of preterm birth isn't clear. According to Dr. Asala, there are factors that increase the risk of premature birth. These include: having a previous premature delivery; pregnancy with twins, triplets or other multiples; problems with the uterus, cervix or placenta; smoking cigarettes or using illicit drugs; poor nutrition; not gaining enough weight during pregnancy; infection of the amniotic fluid and lower genital tract. Other possible factors are with regards to high blood pressure and diabetes; being underweight or overweight before pregnancy; stress or trauma, such as the death of a loved one; multiple miscarriages or abortions; and physical injury such as domestic violence.
Complications associated with preterm birth
Preterm babies need to be constantly attended to. “Doctors ensure that the care provided includes keeping them warm through skin to skin contact or parent-infant attachment (kangaroo care), provide support for their feeding, as well as regularly monitor their vital signs such as heart and breathing rate,” Dr. Asala said. He added that “We do all these things for the reason that being born too early can cause both short-term and long-term health problems for preemies. Some complications may be noticeable at birth, while others may not develop until later.”
Short-term complications
Some preterm birth complications for the short-term pertains to: Breathing problems (e.g. apnea) due to an immature respiratory system; Heart problems commonly with patent ductus arteriosus (PDA) and low blood pressure (hypotension); Brain problems such as bleeding in the brain, known as an intraventricular haemorrhage; Temperature control problems (e.g. hypotherma) as babies don't have the stored body fat of a full-term infant to generate enough heat to replace what's lost through the surface of their bodies. Other complications include: Gastrointestinal problems (e.g. necrotizing enterocolitis (NEC)); Blood problems (e.g. anaemia and infant jaundice); and Immune system problems - an underdeveloped immune system can lead to infection of the bloodstream causing sepsis, a life-threatening complication.
Long-term complications
For the long term complications, premature birth may lead to: cerebral palsy, a brain injury which affects movement; impaired cognitive skills or learning disabilities; vision problems, for example retinopathy of prematurity, which causes blindness. Other complications include: hearing problems and chronic health issues like asthma.
Examining a preterm baby
Dr. Asala indicated that there are some necessary tests and diagnosis doctors have to carry out on the baby. This involves checking the baby’s heart and breathing rate to ensure that everything is fine with him/her. The neonatal intensive care unit (NICU) monitors the amount of fluid your baby receives through feeding (breast milk), intravenous fluids and how much fluid your baby loses through wet or soiled diapers, blood draws and other tests. An Ultrasound scan is carried out to check the baby’s brain for bleeding or fluid buildup or to inspect the abdominal organs for problems in the gastrointestinal tract, liver or kidneys. Also an eye doctor examines the baby's eyes to check for vision problems with the retina (retinopathy of prematurity). “We are there to care for your baby and help to save their lives. If your baby develops any complications, other specialized tests and diagnosis would be needed,” he said.
Care for preterm babies
Caring for preterm babies depends on the severity and possible complications at birth. Medifem’s neonatal intensive care unit (NICU) provides round-the-clock supportive care for all babies, including those born preterm. Some preterm babies are cared for like normal babies, while others require immediate medical care such as monitoring their vital signs - blood pressure, heart rate, breathing and temperature. They are also given medications/antibiotics to boost their immune system and to fight against possible infection. Preterm babies need a lot of breast milk because breast milk contains immunities from the mother and other important nutrients. We advise pregnant women to adhere to hygiene practices and healthy eating during pregnancy. You should also regularly check up the baby with your doctor after you are discharged from the hospital.
Source:
Interview with Dr. Samuel Asala, Medifem Multi-specialist Hospital and Fertility Centre
http://www.mayoclinic.org/diseases-conditions/premature-birth/basics/definition/con-20020050
http://www.healthline.com/health/pregnancy/third-trimester-preterm-delivery#2
http://www.who.int/features/qa/preterm_babies/en/
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