Preterm Birth- Causes, Complications and Care

Everyone in the family is super-excited as the date for the’s delivery is nearing. Becoming a mother for the first time is both, an exciting and nerve-wracking experience. In this time a mother may have read tons of articles and watched numerous videos on pregnancy, tips to stay healthy, and followed the doctor’s advice at each check-up. But, giving birth can have its own set of complications like preterm birth. Have you heard about this? 

 

What is preterm birth? 

Preterm birth or premature birth is a birth that takes place before the completion of 37 weeks of pregnancy. A `

• Extremely preterm (less than 28 weeks) 
• Very preterm (28 to 32 weeks) 
• Moderate to late preterm (32 to 37 weeks) 

Babies may be born prematurely due to spontaneous preterm labor, or due to a medical emergency and early cesarean section. Each year, an estimated 15 million babies are born preterm and complications arising out of preterm birth are the leading cause of death among children less than 5 years of age. 

 

How does preterm birth affect the baby? 

Since preterm babies are born before they reach their full growth, there are different consequences for these little ones. 

 

Characteristics of preterm babies: 

Preterm babies have slightly different physical attributes than normal babies due to the early birth, these include; 

• Disproportionate composition with a large head and a small body 
• Low body temperature 
• Fine hair (lanugo) covering the body 
• Translucent or shiny skin 
• Lesser than average body weight, less than 2.5 kg 

 

Health complications faced by preterm babies: 

Advances in the medical sciences have made it possible for preterm babies to live absolutely healthy lives. However, some of them may experience certain health complications. These are especially seen in extremely preterm babies, and include; 

• Breathing distress due to immature lung development 
• Heart problems including low blood pressure and an opening between the pulmonary (lung) artery and aorta (heart) known as Patent Ductus Arteriosus (PDA) 
• Internal bleeding in the brain 
• Inability to regulate the body temperature due to lack of body fat 
• Gastrointestinal problems 
• Anemia 
• Vision problems due to swelling in the retina of the eyes 
• Hearing problems 
• Learning disabilities 

 

 

 

What are the causes of preterm birth? 

Preterm birth may be spontaneous or due to some other medical conditions like; 

• Infections 
• Complications in pregnancy that require early induction of labor or cesarean section 
• Multiple pregnancies 
• Diabetes 
• High blood pressure 
• Genetics 

In some cases, the exact cause of preterm birth may not be identified at all.  

 

Which risk factors increase the chances of preterm birth? 

A few factors may increase the risk of preterm birth such as; 

• Previous history of preterm birth 
• Multiple pregnancies (twins, triplets, etc.) 
• Uterine problems like those in the cervix 
• Smoking 
• Multiple abortions 
• An extremely small interval between pregnancies (less than half a year) 

 

World Health Organization (WHO) recommendations for preterm baby care: 

On World Prematurity Day 2022, 17th November 2022, The World Health Organization (WHO) launched new recommendations based on new evidence that can improve the care of preterm or low birth weight babies. Some of these recommendations include; 

 

• Kangaroo mother care (KMC) - Here the preterm baby is given continuous skin-to-skin contact by the mother. KMC should be initiated as soon as possible at the health care facility or the home and should be given for 8-24 hours per day. 
• Mother’s breast-milk - The baby’s own mother’s breast-milk is recommended for preterm and low-birth-weight infants. Where this is unavailable, donor human milk may be considered. 
• Preterm milk formula - When both the mother’s breast-milk or the donor milk is not available, a nutrient-enriched preterm formula may be considered for very preterm (< 32 weeks’ gestation) or very low-birth-weight (< 1.5 kg) infants. 
• Early initiation of feeding - Preterm and low-birth-weight infants should be fed as early as possible, from the first day of their birth. 
• Supplementation of nutrients - Supplementation with iron, zinc, vitamins A, D, and probiotics may be considered for preterm infants. 
• Emollients - Topical oils may be applied to the body of preterm and low-birth-weight infants. 

 

How can preterm birth be prevented? 

Certain steps can be taken to prevent preterm birth especially if mother is at a risk of it after consulting with doctor. These include; 

• Surgery - Uterine problems like a short cervix may be corrected through surgery.  
• Progesterone supplements - These supplements minimize the chances of preterm birth in women with a short cervix. 

 

Preterm birth is a challenging phenomenon but by speaking with doctor and taking the right steps, anyone can prevent it.