Premature
birth
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.
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