What is prematurity?
Premature babies (often called "preemies") are babies who are born before the 37th post-conceptional week. Normal (full-term) babies are born between the 38th and 42nd week. Often a preemie's age is defined by the number of post-conceptional weeks until the day the baby actually should have been born (which is in the 40th week of normal gestation). Also later in life, medical professionals often don't count a preemie's premature time in calculating his/her age and defining appropriate growth and developmental level, because a preemie isn't yet fully developed for delivery when he/she is born.
What causes prematurity?
Many factors increase the risk of premature delivery. Some of them are elements within the mother's lifestyle during pregnancy, such as smoking, alcohol use and eating poorly. However, medical problems and pregnancy complications can also lead to premature delivery. Having had a previous preemie also increases the risk for getting a second premature delivery. Women under age 19 or over 35 are also at increased risk for getting a premature baby. Carrying multiple fetuses raises the risk of premature childbirth as well. Still in some cases the cause is simply unknown.
What is a preemie's chance of survival?
There are many factors that influence the baby's chance of survival, such as the baby's gestational age at birth, his/her birth weight, the infant's gender (girls have a slightly better chance of survival than boys), the maturity of rhe infant's organs (especially the lungs), and possible congenital abnormalities. The chances of survival increase as the baby gets older, but estimates are never exact: the baby may suddenly get an infection and die, and some babies survive miraculously.
How is a premature baby treated?
Premature babies are transferred to a Neonatal Intensive Care Unit (NICU), which is an intensive care unit especially designed for newborns. Because preemies don't have the body fat to maintain their own warmth, they are placed in an incubator or radiant warmer. An incubator completely surrounds a baby, whereas a radiant warmer is a warmed bed open to the air. A preemie's critical functions (such as breathing rate and pattern, heart rythm and blood pressure) are constantly monitored. Preemies are often fed through an IV or, if they are older, through a tube. Babies who can't breathe on their own or have problems like Respiratory Distress Syndrome are often put on a ventilator.
What are common problems in preemies?
Breathing difficulty is one of the most commen problems in preemies. This can be caused by several things, such as Respiratory Distress Syndrome (RDS), a problem to make the transition from the womb to breathing air due to a lack of Surfactant in the lungs. Bronchopulmonary Dysplasia (BPD) and Apnea Spells (suddenly stopping to breathe) are also common causes for breathing difficulty in preemies.
Jaundice is another very common problem in preemies. It is caused by high levels of Bilirubin, a compound resulting from the breakdown of blood. Too high levels of this substance can damage the brain, so babies are monitored for jaundice. Treatment involves the placement under lights that help the body lower the Bilirubin levels.
Other common problems in premature babies include:
* Infections, either before, during or after birth;
* Anemia (a deficit of red blood cells);
* Retinopathy of Prematurity (ROP), which involves the abnormal growth of blood vessels in the eye, due to which the retina can be pulled out of position or even detach;
* Intraventricular Hemorrhage (IVH), which is bleeding in parts of the brain called the Ventricles;
* Patent Ductus Arteriosus, in which a blood vessel connecting the main blood vessel supplying the lungs and the aorta doesn't close as it should.;
What special care to preemies need after their NICU-time?
A preemie's growth and development need to be followed closely in order to identify possible problems or disabilities. Some babies are cared for in high-risk newborn clinics. All former preemies receive periodic hearing and eye exams. Close attention is also paid to their neurological development, the achievement of motor skills and their behaviour. Developmental screenings are performed. Some preemies are given additional care by medical specialists. In the Nethelrands preemies are usually followed until the age of about three.
What is a preemie's risk for disabilities?
As with chances for survival, many factors play a role in the risks of having a minor or major disability, such as the baby's gestational age, neurological abnormalities (such as severe intravestricular hemorrhage) and being sick for a long time while bing in the NICU. In 23- or 24-weekers the chance of having a major disability (mental retadation, blindness, deafness or inability to walk without assistance) is approximately 50%, but the chance of being non-disabled gradually increases with age. About two-thirds of preemies will eventually turn out to be able-bodied or have only minor disabilities, such as coordination problems, needing glasses at an early age or specific learning disabilities. About 50% of babies weighing less than 3 1/2 pounds at birth will have a minor disability. Keep in mind that it cannot be predicted whether your child will become disabled. Furthermore, many children with minor or major disabilities lead happy lives.
