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Preterm Birth: What it is, What Its Risks are to Babies

separator Most pregnancies range from 37 weeks to 42 weeks long. When your baby is born within this timeframe, she or he is considered to be a full-term infant. Any birth that comes before 37 weeks is considered premature, or preterm.

A preterm birth is a risk for any baby, but the earlier the birth occurs, the more dangerous it is. In the United States, about 12 percent of babies are born preterm.

  • 84 percent of preterm babies are born between 32 and 36 weeks (many of these babies do quite well, and can breathe and eat on their own or with a little help)
  • 10 percent are born between 28 and 31 weeks (these babies usually weigh between 2 and 5 pounds)
  • About 6 percent are born at less than 28 weeks (babies in the older range usually weigh less than 3 pounds; those less than 26 weeks often weigh only 1 or 2 pounds)

Being born early doesn’t simply mean that a baby is small. The earlier a baby is born, the less likely it is that organs won’t be developed. Babies born at a very early stage in pregnancy are more likely to have lifelong disabilities, such as

  • Cerebral palsy
  • Mental retardation
  • Digestive problems
  • Lung problems
  • Vision and hearing loss

Some of the common problems premature babies have when they’re born include:

Respiratory distress syndrome (RDS): These babies lack a protein called “surfactant,” which keeps small air sacs in the lungs from collapsing. Babies born early can be treated with surfactant. This treatment contributes to a much higher increase in survival rates among premature babies. But sometimes, surfactant isn’t enough to prevent RDS. Babies who have this condition may need to have a tube inserted to help them breathe. They also may be treated with nitric oxide, which helps to relax the blood vessels in the lungs, making breathing easier.

Apnea: This causes babies to stop breathing, sometimes for as long as 20 seconds. Some people describe this as “forgetting to breathe.” Premature babies are always monitored for this.

Bleeding in the brain: This occurs at the highest rates in the youngest of premature babies. In most cases, this bleeding is not serious, but in the more severe cases, pressure on the brain from the bleeding can cause cerebral palsy or learning and behavioral problems.

Chronic lung disease: These babies generally need a ventilator to help them breathe. They’re gradually weaned from the ventilator, and often their lungs improve during the first two years of life. But often, these babies develop chronic lung disease as they get older.

Other problems can include anemia, an immature immune system that has trouble fighting infection and vision problems.

Signs and Symptoms of Pre-term Labor
Your labor is considered “pre-term” if it begins before you’ve completed 37 weeks of your pregnancy. Call your doctor if you have even one of these signs:

  • Contractions every 10 minutes or less (a contraction makes your abdomen feel tight)
  • Blood or other fluid leaking from your vagina
  • Pressure in your pelvis; a feeling that your baby is pushing down
  • An ache in your lower back
  • A crampiness that feels like your period
  • Cramps in the abdomen that are or are not accompanied by diarrhea

Your doctor is likely to either ask you to go to the office or the hospital to be checked or to stop what you’re doing right away and rest.

Who’s at Risk for Giving Birth Prematurely?
Sometimes, a baby has to be born early because of complications that arise during pregnancy or because of a health problem in the mother. In cases like that, doctors induce labor. But most of the time, premature labor begins for reasons that doctors don’t understand. Some researchers believe that infection may be the cause, in the amniotic fluid or the fetal membranes. But most of the time, doctors just aren’t sure why labor begins early. And when it does, there’s often not much they can do to stop it.

Any pregnant woman can go into labor prematurely. But some research has indicated that women are at higher risk of premature labor if:

  • They’ve had a previous premature birth
  • They are pregnant with more than one child
  • They have certain conditions in the uterus or cervix

Additional women at risk for premature labor include:

  • African-American women
  • Women who are younger than 17 or older than 35
  • Women with low incomes

Additional lifestyle factors that put women at risk for premature labor include:

  • Getting little or no care from a doctor when you’re pregnant
  • Smoking
  • Drinking alcohol
  • Using illegal drugs
  • Being a victim of domestic violence
  • High stress levels
  • Long work hours
  • Little social support

Certain illnesses also increase a woman’s risk of premature labor. These include:

  • Diabetes
  • High blood pressure
  • Clotting disorders
  • Being obese or underweight before pregnancy
  • Sexually transmitted disease
  • Short period of time between pregnancies (6 to 9 months)

If your doctor suspects you might be likely to go into labor early, you may receive steroids, such as surfactant, which can help the lungs develop faster. You may also get a medication that can help postpone labor.

The March of Dimes; American College of Obstetrics.
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