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Premature birth
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Premature birth

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WOMEN'S HEALTH

Pregnancy

Premature babies have less time to fully develop and mature in the womb. As a result, they're often at increased risk of medical and developmental problems. One of the biggest problems facing premature infants is underdeveloped lungs.

Your doctor may try to delay your baby's birth if you go into labor earlier than around 34 weeks into your pregnancy (preterm labor). Even a few extra days in the womb can give your baby's lungs a chance to become more mature. But sometimes, in spite of every effort, your baby may be born early.

Complications

Premature labor may create complications for you, for your baby or for both of you:

For mothers
By itself, premature labor won't put you at any physical risk unless it's the result of another problem, such as a uterine infection. But all treatments used to delay delivery carry some risks.

Medications that halt uterine contractions often cause fluid to collect in the mother's lungs. This causes breathing difficulties and can pose a risk for both you and your baby. Other side effects depend on the medication used to stop labor. Some medications can lead to fatigue and muscle weakness. Others may cause a rapid heart beat, blood sugar abnormalities or stomach ulcers.

You and your doctor will need to consider your own risk if medications are used to stop labor, as well as the risks to your baby if he or she is born too soon.

For babies
If your baby is premature, how well he or she will thrive depends largely on the baby's gestational age at birth. Risks are greatest for the babies born most prematurely — those born between 23 and 26 weeks gestation.

About a third of these smallest survivors, who weigh less than 2 pounds at birth, will have serious medical problems such as cerebral palsy, fluid accumulation in the brain (hydrocephalus), seizures, lasting neurologic problems or developmental delays. Another third will have some less-serious chronic problems, such as mild cerebral palsy, the need to wear glasses and have ongoing eye care, or more mild developmental delays.

Other babies born at 23 to 25 weeks do very well at first and may show no signs of problems when they go home from the hospital. But as childhood progresses, many of these children display some difficulties related to their premature birth. In particular, they may not perform as well in school as other children their age.

Very premature babies are also at risk of other conditions:

  • Bleeding in the brain (intracranial hemorrhage). If this occurs, it's usually in the first week to 10 days of life. The more severe the bleeding, the greater the likelihood that the child will develop serious problems, including developmental delays, seizures, learning disabilities and fluid accumulation in the brain.

  • Retinal problems. Another complication seen in the youngest and most vulnerable premature babies is retinopathy of prematurity (ROP), an abnormal growth of blood vessels in the retina, the light-sensitive inner lining of the eye. ROP probably occurs because the vascular system in the baby's eye hasn't fully developed. Many cases of ROP disappear on their own, but sometimes the condition leads to scarring. The most serious cases may be treated with cryotherapy, a procedure in which an extremely cold instrument is used to help prevent the baby's retina from becoming detached. Sometimes lasers are used in a similar manner to treat ROP.

  • Intestinal problems. Some preemies are also at risk of a potentially severe intestinal problem known as necrotizing enterocolitis (NEC). In the most serious cases, this condition can be life-threatening. Infants who have milder cases of NEC need to be fed intravenously and given antibiotics for 1 or 2 weeks.

  • Sudden infant death syndrome (SIDS). Premature babies are at increased risk of SIDS, a mysterious condition that claims the lives of about 2,500 infants each year.

But not all preemies have medical or developmental problems. By 28 to 30 weeks, the risk of these complications is much lower. And for babies born between 32 and 35 weeks, most medical problems are short-term and may even have resolved by the time the baby comes home from the hospital.

Premature birth > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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