The WHO defines prematurity as the children born before the week 37 of pregnancy, after the mother has had her last menstrual period.
In the United Kingdom in 2005, there were 11.657 infants born before the week 33 of pregnancy, but more than 90% of them survived after birth. Only by labeling all the children who were born before the week 37, we fail to illustrate the severity of these various cases:
- A child born in the week 36 of pregnancy will probably fed himself slower.
- A child born before the week 33 will have more serious problems, such as lungs that aren`t completely developed.
- A baby born before the week 28 will have a lot of serious problems, but the survival rate is still remarkable.
It`s pretty common for premature babies and have an intrauterine growth restriction, which effects the established prognosis negatively. Survival rates can be misleading because it varies a lot between the following units. – Read more!
- If the baby has over 800g, he has a 90% chance of survival.
- If the baby has over 500g, he has a 50% chance of survival.
- If your baby was born before the week 28 of pregnancy, he has 80% chance of survival.
Note: These figures hide certain major inabilities of the surviving babies.
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The child who is small in gestational age may have little subcutaneous fat and it`s possible that the skin is wrinkled.
Because the mortality rate has dropped, emphasis is placed on perinatal intervention to reduce long-term morbidity, especially to prevent brain injury and abnormal development. The baby born prematurely need to face an increased number of issues, which may be more accentuated if the baby suffers of intrauterine growth restriction.
- Hypothermia is a high risk, especially if the baby doesn`t have sufficient subcutaneous fat. A premature baby is less able to shake and maintain homeostasis.
- Hypoglycaemia is another risk, especially if the baby is small as gestational age. Another serious complication may be hypocalcemia. Both can lead to seizures which can cause long-term brain damage.
- The sooner the baby was born, the higher the chance of developing the respiratory distress syndrome. The steroids taken before birth may reduce this particular risk, but not that much. If the baby needs oxygen, then he may be susceptible to retrolental fibroplasia and blindness.
- The baby born prematurely has a high risk of developing neonatal and nuclear jaundice, if he has a low level of bilirubin.
- Babies born prematurely are susceptible to infections and necrotizing enteritis.
- Babies born prematurely are susceptible to intraventricular hemorrhage of the brain, with a serious effect on the long term.
All these problems can be solved by a neonatologist, but if the baby is discharged and taken home with the family, it doesn`t mean that the problems are over. Babies before term will most likely have a few or no problem on the long term, unlike those who were born very early, who needed to fight a lot to survive and suffer of more serious complications.
Development Problems of Premature Babies
Morbidity is inversely proportional to gestational age. However, there`s no gestational age to be exempt from this issue. Severe diseases, such as cerebral palsy, deafness or blindness, may affect between 10% and 15% of babies who were born before term. There is some evidence that the cerebral palsy incident occurs in babies born between weeks 28 and 31 of pregnancy.
The figures on the outcomes of rehabilitation when premature babies are concerned should be interpreted with caution.
- Percentages should be considered with caution.
- Different studies use different criteria to determine the degree of prematurity.
- There`s a degree of risk.
- Being born prematurely and with a small weight, this increases the chances of future complications.
Intrauterine growth restriction may have an essential effect in premature babies, influencing the development of the brain and leading to poor IQ. Infants who were born before the week 33 of pregnancy continue to show a lack of brain development when they are younger as well as an outbreak of growth when reaching the threshold of adolescence.
Seeing & Hearing
About 1 in 4 children, with a weight of below 1.5 kg at birth, suffer from peripheral or central hearing impairment, or both.
Infants undergoing premature examinations or treatments for retinopathy of prematurity have improved their structural functionality over those who receive conventional tests or don`t receive them at all. However, due to the higher number of premature babies who have a low birth weight the aggressive prevalence of prematurity retinopathy has increased.
There`s a study that shows that 66% of children under 1.25 kg developed retinopathy of prematurity, but only 6% of them required any treatment.
As mentioned above, intestinal problems are on occasion caused by an illness known as necrotizing enterocolitis. Intestines aid the organism digest food, and while some babies with necrotizing enterocolitis improve their health, some might experience intestinal issues later.
Premature babies may experience dental issues, which may include teeth that develop out of place, tooth growth or changes of tooth color.
Some infants born prematurely may experience infections more easily than others. These may include meningitis (brain infection) or pneumonia (lung infections). – Click on this link!
Admissions to the Children`s Hospital
Children with low birth weight (500g – 999g) have more readmissions to the hospital as they have a lot more health issues than other babies. These problems include respiratory issues, which is also the main cause for these readmissions.
The Pre-School Period
Neuromotor and cognitive deficits at age 5 occur more with the decrease in gestational age. A lot of these children require a special care level.
- Around half of the babies born between the week 24 and 28 of pregnancy have some sort of a disability at the age of 5, similar to the proportion observed in a study in the United Kingdom.
- For newborns who are born between the week 29 and 32 of pregnancy, nearly 1/3 of them develop some kind of a disability at the age of 5.
Behavioral & Psychomotor Issues
Another study has analyzed children with ages of 7 to 8 years old who were born before the week 32 of pregnancy and were able to attend a normal school. They were compared to those normally born of the same age.
- Disabilities can be subtle and numerous, so a relatively large number of tests have been made.
- Babies born prematurely have a greater predisposition to having motor issues and this may have affected them even though their intelligence was the same as normal children.
- A little over 30% of children developed in coordination disorder, while only 6% of classmates suffered from this medical problem.
- Premature babies have a tendency to be a lot more active, impulsive, distracting and lacking in persistence. They also have a tendency of overestimating their abilities.
- Overactive attention deficit disorder was found in 8.9% of infants born prematurely.
- The children who were born earlier weren`t necessarily the children with the lowest score in school.
Although most disabilities have been reduced, studies show that they are pretty much the same as babies born prematurely 10 or 20 years ago, despite technological advances.
Taking Care of Premature Babies at Home
As long as the premature baby is at neonatology, the medical staff can help you with guidelines about how to take care of your baby at home:
- The nutritionist will take care for your baby to have a proper diet.
- The physiotherapist will show you practical ways to encourage the development of your baby.
- One or more specialists will be available in case your baby needs surgery or treatment.
- Nurses who will answer your questions and teach you how to take care of a premature baby.
When you`ll take your baby home, you should already have all the basic notions about his special needs, and any time you have questions or need more details about a certain thing, talk to your doctor to be better informed. – Click here!
Usually, the pediatrician talks to mothers about the possible health issues of premature babies. Otherwise, the uncertainty of the parents is troubling, so ask questions every time you need a answer for something you aren`t sure.
A lot of the things parents learn from the press about learning processes and children`s behavior are based on studies which target the youngest and most infantile babies who have the greatest risks.