Premature Birth -
Causes, Incidents & Risk Factors
What is premature birth?
Full-term pregnancies usually last about 40 weeks. A baby born between 37 and 40 weeks of pregnancy are considered full term. Babies born three or more weeks early are premature.
Babies who are born closer to 32 weeks (just over seven months) may not be able to eat, breathe or stay warm on their own but do not face serious problems after a short hospital stay.
Babies born earlier than 26 weeks (just under six months) are the most likely to have serious problems. If your baby was born very small or sick, you may face some difficult decisions about treatment.
Premature birth is a serious health problem. Premature babies are at increased risk for newborn health complications, such as breathing problems, and even death. Most premature babies require care in a newborn intensive care unit (NICU), which has specialized medical staff and equipment that can deal with the multiple problems faced by premature infants.
St. Vincent’s FBC newborn intensive care unit is equipped to handle the vast majority of medical situations and contingencies including the birth of babies after 30 weeks gestation. Three neonatologists (pediatricians specializing in premature infants and those requiring special monitoring and care) along with board-certified pediatricians are among our staff of medical specialists providing 24/7 coverage.
Problems are associated with premature births
Babies who are premature may not be able to feed by mouth, breathe without stopping or stay warm. Their bodies simply need more time to fully develop and grow. After they outgrow the problems caused by being born too soon, most babies can safely go home from the hospital.
When a baby is born early, his or her major organs are not fully formed. This can cause health problems. Any premature baby can have medical problems. But those who are born before 32 weeks are more likely to have more serious problems.
Having a premature baby may be stressful and scary. To get through it, you and your partner must take good care of yourselves and each other. St. Vincent’s Medical Center can also put you in touch with a spiritual advisor, counselor, social worker or a support group of other parents who are going through a similar situation.
What causes premature birth?
Premature birth can be caused by a problem with the fetus, the mother, or both. Often the cause is never known. Most premature births are caused by spontaneous preterm labor, either by itself or following spontaneous premature rupture of the membranes (PROM). With PROM, the sac inside the uterus that holds the baby breaks too soon. Preterm labor is labor that begins before 37 completed weeks of pregnancy. The causes of preterm labor and PROM are not fully understood.
The most common causes include:
- Problems with the placenta.
- Pregnancy with twins or more.
- Infection in the mother.
- Problems with the uterus or cervix.
- Drug or alcohol use during pregnancy.
What kind of treatments can a premature infant need?
Premature babies who are moved to the neonatal intensive care unit (NICU) are watched closely for infections and changes in breathing and heart rate. Until they can maintain their body heat, they are kept warm in special beds called isolettes.
They are usually fed through a feeding tube through a vein (intravenously), depending on their condition. Tube-feeding lasts until a baby is mature enough to breathe, suck and swallow and can take all feedings by breast or bottle.
Sick and very premature infants need special treatment, depending on what medical problems they have. Those who need help breathing are aided by an oxygen tube or a machine, called a ventilator. Some babies need medicine. A few need surgery.
Breast milk can give a baby extra protection from infection. So your hospital may urge you to pump your breast milk and bring it in for at least the first few weeks after the birth. To facilitate the breast-feeding process, our St. Vincent’s Family Birthing Center lactation consultants are readily available. All of the FBC’s staff are also specially trained as breastfeeding support specialists and ready to guide Mother through the 10 steps developed by BFHI to succeed at this satisfying and healthful feeding method.
NICU doctors and nurses are specialists in premature infant care. If your premature baby is in NICU, you can learn a lot from the medical staff about how to take care of your baby.
What medical complications are common in premature babies?
There are a number of complications that are more likely in premature than full-term babies such as Respiratory distress syndrome (RDS): Apnea, Intraventricular hemorrhage (IVH), Heart problems, Intestinal complications, Vision problems, Jaundice, Anemia, Chronic lung disease (also called bronchopulmonary dysplasia or BPD) and Infections.
Can long-term problems result from premature birth?
Before the birth, it is hard to predict how healthy a premature baby will be. But your doctors can prepare you for what may lie ahead. They can base this on your condition and how many weeks pregnant you will be when you give birth.
Most premature babies do not develop serious disabilities. But the earlier a baby is born, the higher the chances of problems.
- Most premature babies who are born between 32 and 37 weeks do well after birth. If your baby does well after birth, his or her risk of disability is low.
- Babies most likely to have long-term disability are those who are born before 26 weeks or who are very small, 1.7 lb (771.1 g) or less. Long-term problems may include intellectual disability or cerebral palsy.
What can you expect when you take your baby home?
When you're at home, don't be surprised if your baby sleeps for shorter periods of time than you expect. Premature babies are not often awake for more than brief periods, but they wake up more often than other babies. Because your baby is awake for only short periods, it may seem like a long time before he or she responds to you.
Premature babies get sick more easily than full-term infants. So it’s important to keep your baby away from sick family members and friends. Make sure your baby gets regular checkups and shots to protect against serious illness.
Sudden infant death syndrome (SIDS) is more common among premature babies. So make sure your baby goes to sleep on his or her back. This lowers the chances of SIDS.
What women are at increased risk for premature birth?
Any woman can give birth prematurely but some women are at greater risk than others. Researchers have identified some risk factors, but providers still can't predict which women will deliver prematurely.
Three groups of women are at greatest risk for premature birth:
- Women who have had a previous premature birth
- Women who are pregnant with twins, triplets or more
- Women with certain uterine or cervical abnormalities
- Certain lifestyle factors may put a woman at greater risk for preterm labor. These include:
- Late or no prenatal care
- Drinking alcohol
- Using illegal drugs
- Exposure to the medication DES
- Domestic violence (including physical, sexual or emotional abuse)
- Lack of social support
- Extremely high levels of stress
- Long working hours with long periods of standing
- Exposure to certain environmental pollutants
Certain medical conditions during pregnancy also may increase the likelihood that a woman will have preterm labor. These include:
- Infections (including urinary tract, vaginal, sexually transmitted and other infections)
- High blood pressure and preeclampsia
- Clotting disorders (thrombophilia)
- Being underweight before pregnancy
- Short time period between pregnancies [One study found that an interval of less than 18 months between birth and the beginning of the next pregnancy increased the risk of preterm labor, though the greatest risk was with intervals shorter than 6 months (9). A woman should discuss with her provider the best pregnancy spacing for her.]
- Being pregnant with a single fetus that is the result of in vitro fertilization
- Birth defects in the baby (10)
- Bleeding from the vagina
- Certain demographic factors also increase the risk:
- Non-Hispanic black race
- Younger than age 17, or older than age 35
- Low socioeconomic status
Even if a woman has one or more of these risk factors, it does not mean that she will have preterm labor. However, all women should learn the signs of preterm labor and what to do if they have any of them.
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