Overview
Premature birth is when a baby is born before the completion of 37 weeks of pregnancy. It is categorized based on the weeks of pregnancy, with the following terms: late preterm (34-36 weeks), moderately preterm (32-34 weeks), very preterm (28-32 weeks), and extremely preterm (before 28 weeks). The earlier the baby is born, the higher the risk of health challenges. Premature birth can lead to short-term and long-term medical problems, including breathing difficulties, feeding problems, and developmental delays.
Understanding the disease
Symptoms
The symptoms of premature birth can vary depending on the gestational age at which the baby is born, but some common signs include:
- Small size, with a head that's large compared to the body.
- Sharper and less rounded features due to a lack of stored fat.
- Fine hair covering the body.
- Low body temperature, especially right after birth.
- Breathing difficulties.
- Feeding problems. It's important to note that some premature babies may have very mild symptoms, while others may experience more serious health challenges. The risk of complications increases as the baby is born earlier and lower the birth weight is.
Risk Factors
Risk factors for developing premature birth include:
- Multiple pregnancies (e.g., twins, triplets, or other multiples)
- Short interval between pregnancies (less than 6 months)
- Assisted reproduction, such as in vitro fertilization
- History of miscarriage or abortion
- Previous premature birth
- Certain health conditions, such as issues with the uterus, cervix, or placenta, infections, high blood pressure, or diabetes
- Lifestyle choices, such as smoking, drug use, heavy alcohol consumption, being underweight or overweight, or experiencing stressful life events It is essential to note that not all premature births have identifiable risk factors.
Development
Premature births occur when a baby is born before the 37th week of pregnancy. Premature babies are at a higher risk for health challenges, and the earlier the birth, the greater the risk. There are different stages of premature birth, including:
- Late preterm: Born between 34 and 36 completed weeks of pregnancy.
- Moderately preterm: Born between 32 and 34 weeks of pregnancy.
- Very preterm: Born between 28 and 32 weeks of pregnancy.
- Extremely preterm: Born before 28 weeks of pregnancy. Most premature births happen in the late preterm stage. Risk factors for premature birth can include various health problems, infections, lifestyle choices, and certain demographics. Premature babies may experience short-term complications like breathing problems, while long-term complications can range from mild to severe.
Assessment and Diagnosis
Triage
You should see a doctor if premature birth is suspected, especially if your baby shows any signs of being born too early, such as small size, large head compared to the body, features that are sharper and less rounded than a full-term baby's features, fine hair covering the body, low body temperature, trouble breathing, and feeding problems.
Diagnosis
To diagnose premature birth, medical professionals will closely monitor the baby's breathing and heart rate, track fluid intake and output, and perform blood tests to check levels of important substances such as calcium and blood sugar. In some cases, a pelvic exam may be done to check the cervix and monitor contractions. If there are signs of prolapsed fetal membranes, further tests like an amniocentesis may be done to check for infection in the amniotic sac and fluid. No reliable tests can predict an incompetent cervix before pregnancy, but ultrasound or MRI can help identify congenital problems with the uterus that might cause an incompetent cervix.
Management and Treatment
Complications
Complications of premature birth can be short-term and long-term. Short-term complications may include breathing problems due to underdeveloped lungs, metabolism problems, and immune system issues. Long-term complications may include cerebral palsy, problems with learning and development, and a higher risk of chronic health conditions. Premature babies are also more susceptible to infections. It is important to monitor the health of premature babies closely and address any issues promptly to ensure the best possible outcomes.
Prevention
While there may be ways to lower the risk of premature birth, it is important to note that not all cases can be prevented. Some risk factors, such as a history of previous premature births or certain health conditions, may be beyond personal control. However, taking steps to promote a healthy pregnancy, such as avoiding smoking, drinking, and illicit drug use, maintaining a healthy weight, and seeking proper medical care, can help reduce the likelihood of premature birth. Additionally, discussing any concerns or risks with a healthcare provider is essential in managing and addressing potential issues.