Ask the Experts: Learn about care, health complications of babies born too early

Dr. Prashant Malviya
·4 min read

Premature birth occurs when a baby is born before 37 weeks of pregnancy have been completed. It’s a serious health crisis that affects about 380,000 babies in the United States each year.

This Prematurity Awareness Month, take time to learn about the care and health complications of babies born too early, as well as the risk factors and preventive measures for mothers.

Who is at risk for preterm labor and birth?

There are several risk factors that health care providers attribute to preterm labor and birth. A woman is considered high risk if she:

  • Has had a previous premature birth

  • Is pregnant with multiples (twins, triplets or more)

  • Has complications with her cervix, uterus or placenta

  • Has chronic health problems (high blood pressure, diabetes, thyroid disease)

Some risk factors are modifiable, though, and can be changed to reduce the risk of a premature birth. These include:

  • Not getting prenatal care

  • Smoking cigarettes

  • Drinking alcohol

  • Using illicit drugs

What health risks do premature babies potentially face?

Not all premature babies experience health problems. However, some babies who are born too early can face short-term and long-term complications. The earlier a baby is born, the higher the risk of complications.

Short-term complications that premature babies may experience include:

  • Breathing problems. Premature babies experience breathing problems because of their underdeveloped respiratory system. Some babies born before 34 weeks of pregnancy develop respiratory distress system (RDS) caused by a lack of surfactant. Surfactant is a protein that keeps small air sacs in the lungs from collapsing. Bronchopulmonary dysplasia (BPD), a condition that causes fluid in the lungs and scarring, can also affect premature babies.

  • Feeding problems. Premature babies born before 34 weeks have not yet developed the oral skills necessary to feed by mouth, which requires coordination between sucking, swallowing and breathing. These babies receive nutrition support via IV administration and/or feeding by gavage tube. Babies need to learn how to feed orally (breastfeeding or bottle feeding) prior to being discharged from NICU.

  • Anemia. Anemia is a low number of red blood cells. Premature babies are prone to this because their bodies do not make very many red blood cells.

  • Heart problems. Premature babies might experience low blood pressure or patent ductus arteriosus (PDA). PDA is a persistent opening between two major blood vessels near the heart, but it often closes on its own.

  • Apnea. Apnea is a delay in breathing for 20 seconds or more.

  • Jaundice. This condition causes a baby’s skin and eyes to look yellow. Although it is common among full-term babies, premature babies are even more susceptible to it as their livers might not be fully developed or working well.

  • Infections. Premature babies are born with an underdeveloped immune system. This means that they are more susceptible to infections like pneumonia, sepsis and meningitis until their immune system matures.

  • Cerebral hemorrhage. Premature babies born before 32 weeks are at risk for having cerebral hemorrhages due to their immature blood vessels. The more premature the baby is, the higher the risk of cerebral hemorrhage complications. A cerebral hemorrhage can increase the risk of mortality and long term complications including cerebral palsy, learning disabilities and developmental delays.

Long-term complications that premature babies may experience include:

  • Cerebral palsy. Cerebral palsy, which affects movement and muscle tone, is caused by brain injury during pregnancy or early in the baby’s life.

  • Hearing and vision problems. Premature babies are at risk for hearing loss and vision impairment, particularly those born before 30 weeks.

  • Respiratory problems. Children who were born prematurely are more likely to develop asthma, bronchitis, croup and other respiratory conditions.

  • Learning problems. These may go unnoticed until the child is in school.

What are the signs and symptoms of preterm labor?

Preterm labor occurs when regular contractions of the uterus result in changes in the cervix that start before 37 weeks of pregnancy. According to the American Congress of Obstetricians and Gynecologists, a woman may be having preterm labor if she experiences any of these signs of symptoms before 37 weeks of pregnancy:

  • Change in her vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual

  • Pressure in her pelvis or lower belly, like her baby is pushing down

  • Constant low, dull backache

  • Belly cramps with or without diarrhea

  • Regular or frequent contractions that may or may not be painful

  • Her water breaks

If you have any sign or symptom of preterm labor, make sure to call your health care provider right away.

What is neonatal intensive care?

Premature babies born with health complications need around-the-clock care following birth. Some babies may need support to breathe while others need support to eat and stay warm. IU Health Ball Memorial Hospital has a fully-staffed and equipped Level III neonatal intensive care unit and nursery to provide specialized care to these babies. The length of a baby’s stay in the NICU depends on the severity of his or her health condition. Generally, a baby is ready to go from the hospital when he or she:

  • Can breathe on his/her own

  • Weights at least 4 pounds

  • Can keep warm without the help of an incubator

  • Can breastfeed or bottle feed

  • Gains weight steadily

Dr. Prashant Malviya is a pediatrician specializing in neonatology at Indiana University Health Ball Memorial Hospital. To learn more, visit iuhealth.org/ball-memorial/womens-health/.

This article originally appeared on Muncie Star Press: Learn about care, health complications of babies born too early