What kind of problems do preterm infants experience?

Birth of a fetus prior to 20 weeks is known as miscarriage or spontaneous abortion, since survival is impossible in such cases.

• Labor that begins between 20 and 37 weeks is "preterm labor."
• A baby born at 24 weeks gestation has around 50 percent chance of survival.
• A baby born at 26 weeks gestation has around 80 percent chance of survival.
• A baby born at 28 weeks gestation has around 91 percent chance of survival.
• For a baby who is born after 28 weeks and that weighs more than 3 pounds, the chances of survival are further increased.
• After 32 weeks gestation, a baby has 96 percent chance of survival and a significant decrease in chances of suffering from any significant health problems. Babies who are born between 34th and 36th week of pregnancy are likely to have slight developmental delays, but are unlikely to experience any long-term effects.

Problems which Preterm Infants Experience

Generally speaking, the earlier a baby is born and the lower the birth weight, lower are the chance of survival and higher the chances of handicap. Preterm babies are likely to suffer from a host of problems associated with immaturity of either some or all of their organs.

• The natural mechanisms which combat infection are not properly developed, so preterm infants are usually prone to developing infections.

• Their skin is extremely thin and underdeveloped, with very less subcutaneous fat (that is the fat under the skin), hence they quickly lose heat and it is difficult to keep them warm.

• The lungs lack a substance known as surfactant, which helps them expand. This creates difficulty in picking up sufficient oxygen from the atmosphere and removing the carbon dioxide from blood - a condition known as respiratory distress syndrome.

• The stomach may possibly not be adequately developed to accept milk immediately.

• The sucking reflex may be absent at birth.

• The liver is immature; hence jaundice is common and could be dangerous if severe.

• Blood vessels that supply the brain may be particularly fragile as well as sensitive to damage, which in turn results in bleeding inside the skull. Depending upon the degree of bleeding involved, this could have potentially serious long-term consequences, for instance, physical and mental handicaps or cerebral palsy.

Where the Preterm babies should be delivered?

Preferably, babies who are born preterm should be delivered in hospitals that are prepared to take care for their special needs with neonatal intensive care nurseries. Obstetricians and pediatricians are very often able to predict, before birth, whether the baby is likely to need intensive care facilities, and, in such special cases, the mother can be transported to that facility before delivery.

Parents who are at risk for delivering a premature baby could possibly benefit from a visit to NICU and a discussion with the neonatologists during pregnancy, so that the equipment and care shall not be so intimidating after delivery.

How are Preterm Babies supposed to be delivered?

Preferably, all normal preterm babies who are positioned with the heads down ought to be delivered vaginally by an experienced physician. Cesarean section could increase the risk to the mother without improving outcome for the baby.

• There is no indication for routine use of forceps, though an episiotomy (that is an incision in perineum, the area between vagina and anus) can help to reduce the pressure present on the delicate head of the premature infant.

• Incase complications develop, it could be necessary to deliver immediately by Cesarean section for minimizing any harm to the baby.

• Most physicians deliver breech (that is, bottom first) babies by Cesarean section.