Preterm babies: Causes, risks and preventive measures

preterm delivery
There are several causes for preterm delivery. (Representative image)
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Premature birth is a problem that has been haunting mankind for ages. However, modern medicine has studied the condition and introduced procedures to tackle the situation.

For instance, Patrick, born on August 9, 1963 had spent only 34 weeks in the womb and weighed a mere 2.11 kg. He had breathing issues since birth and died within 36 hours.

In fact, it would need 40 weeks for a foetus to be ready for delivery. However, a baby can be considered fully developed by 37 weeks. Children born between 34 and 37 weeks are termed late preterm and would not face serious health issue like preterm babies. However, they will not be as healthy as term babies and may have difficulties in sucking milk. Moreover, late preterm babies have a high chance of suffering from jaundice.

The real preterm babies are born before 34 weeks from conception and those having a maturity of less than 28 weeks are called extreme preterm.

A foetus achieves viability at 23-24 weeks and so all babies above this maturity are given a chance to survive by medical intervention. However, for the same reason, a foetus below 23-24 weeks of development is usually not given resuscitation.

Causes

There are several causes for preterm delivery. They include high blood pressure, diabetes and infection in carrying women. Among infections, the one related to the urinary tract is a major reason for premature birth of children. Other conditions leading to premature babies are multiple pregnancy and ante partum haemorrhage.

The earlier the birth, the babies would have more chances of suffering from various health issues. So, it is advisable to choose a hospital with all facilities to handle premature cases for delivery rather than shifting a premature baby there after birth. All organs would have developed in premature babies too but they may not be functioning normally.

Here is a list of issues related to premature babies, preventive measures and treatment methods.

Delivery

The body temperature of preterm babies has a high chance to fall rapidly. To tackle this problem, the temperature of the labour room is raised a little. On delivery, the baby is immediately cleaned and shifted to a warmer place before the subsequent procedures are carried out. At the neonatal intensive care unit (NICU) too, the newborns would be kept in a warmer or incubator.

The first breath or cry of a baby is considered crucial. In womb, the lungs of the baby would be full of fluid, which has to be withdrawn and the area filled with air during the first few breaths or cries. A preterm baby has a high tendency not to cry or may emit weak cries. This makes it essential for giving them emergency artificial respiration.

The amount of blood in the body of premature babies has also been found to be lesser than normal. This calls for extreme care to avoid blood loss.

RDS

Respiratory distress syndrome (RDS) is a major problem affecting preterm babies and caused by deficiency of surfactant. Steroid infection for mothers can solve the issue to some extent. However, some children may need surfactant externally.

In addition, some kids may need artificial means of respiration like ventilator, CPAP, HFNV or Oxygen

AOP

Apnea of Prematurity (AOP) refers to a condition in which the baby forgets to breathe. It can be solved by injections or shifting to a ventilator till 34 weeks.

PDA

Patent Ductus Arteriosus (PDA) is a condition in which pure and impure blood mixes and can be treated with paracetamol, ibuprofen or even surgery.

IVH

Intra ventricular haemorrhage (IVH) occurs when undeveloped blood vessels break, leading to blood flooding the brain. Minor bleeding may get repaired itself but major ones may need surgery.

NEC

A digestive problem occurring in some premature babies, Necrotizing Enterocolitis (NEC) is tackled by late feeding of milk. In cases, antibiotics or surgery may be needed.

Hypoglycemia

Babies born preterm have a high chance for displaying this condition. They can be given fluid through blood or be fed milk.

Newborn jaundice

This may not be life-threatening but may need treatment. In most cases, phototherapy would be sufficient.

Anaemia

In newborns having this condition, blood transfusion may be needed. Giving iron tonics up to attaining the age of one year is another method to check anaemia of prematurity.

Infections

Premature babies can easily suffer from infections as their resistance would be low. As a result, visitors to ICU are restricted. Hands have to be cleaned each time before the baby is handled. Sometimes, antibiotics or antifungals are given.

Retinopathy of prematurity

In this condition, blood vessels in the retina get enlarged and may even bleed. Regular tests are needed to identify this malady and treatments with laser are available.

Other conditions

Pneumothorax and pulmonary haemorrhage are two issues found in babies given artificial respiration. They need immediate treatment to avoid death.

Care at home

» Wrap the baby always to give warmth. Cold conditions are harmful.

» Get kangaroo mother care (KMC) before leaving hospital. Studies have shown that KMC boosts the confidence of mothers as well as quantity of breast milk.

» After the baby grows to 2-2.5 kg, bath can be started. Even oil can be used but wipe immediately.

» Conduct regular check-ups in hospital.

» Give vitamin, iron and calcium tonics

» Administer all vaccinations without fail.

» Control visitors to prevent infection

» Touch the infant only with clean hands. Not more than two persons should handle the baby.

» BERA, a checkup of the ear and ROP, that of the eyes, should be carried out without fail.

» From six months, give other foods too along with breast milk.

After overcoming the initial problems, premature babies would display catch up growth and reach the levels of normal babies by two years.

The baby Patrick was the son of the then US President John F Kennedy, who received the best treatment at a hospital in Boston but did not survive. The cause of death was hyaline membrane disease or respiratory distress syndrome. Research carried out later led to the creation of surfactant.

Now science has advanced so much that the youngest baby to survive is a 23-week delivery with 244 grams in California in the US. In India, the record goes to a baby that was born weighing 375 grams and in Kerala it was a baby weighing 380 grams. In the US, 50 per cent of babies born after 24 weeks survive. Medical professionals in India are working hard to reach such levels of survival.

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