Premature Birth: Survival and Health Concerns

A preterm, premature or preemie baby is one who is a baby born too early, or about three weeks before the due date. While normal pregnancies last a period of about 40 weeks, preterm birth occurs at 37 weeks or earlier. We understand that preterm births are one of the most challenging experiences for a family, both physically and emotionally and demand a great deal of courage and stability to stand through it. Our heart goes out to all those who have to live through this difficult time and we wish you all the strength in the world. 

This article is aimed at spreading awareness about the issues associated with premature births, both for the baby and the pregnant females. If you wish to know about the reasons behind premature labour, warning signs and measures to be taken to prevent premature labour, here is an article for you– Premature Birth: Causes, Warning Signs and Preventive Tips. 

Before we get to the bridge, let’s first familiarize ourselves with a few terminologies and facts so that we become the right channel towards making this world a better place for our babies of today, tomorrow and years to come. 

(Preterm Labour, Premature Labour), (Preterm Birth, Premature Birth) – How similar or different are these terms? 

First things first, preterm and premature are literally synonymous, i.e. they mean the same thing and you can use them interchangeably. 

Labour is a series of continuous, progressive contractions of the uterus that help the cervix dilate and thin out for the fetus to move through the birth canal. Labour is further divided into 4 stages where the second stage is the birth of the baby. However, unlike the cases of normal pregnancies (beyond 37 weeks) where early labour is a preparatory sign for the birth of the baby, preterm labour doesn’t always lead to preterm birth. Preterm labour may stop on its own, or with the right and timely treatments. 

Once a baby is born there are a number of factors at play that play a significant role in deciding whether the baby will survive and what its life will be like. Let’s take a look at the most prominent ones. 

Factors Contributing Towards The Survival Of A Preemie Baby

1. Gestational Age

Premature babies are divided into 4 categories on the basis of the age of their viability. 

• Late Preterm – Babies born between 34 and 36 weeks.
• Moderately Preterm – Babies born between 32 and 34 weeks.
• Very Preterm – Babies born between 28 to 32 weeks.
• Extremely Preterm – Babies born before 28 weeks

This is the most common factor used to predict the survival capabilities of premature babies. The older the gestational age, the higher the survival rate since the baby has more time to develop inside the mother’s womb. Babies with a greater gestational age also have a very low risk of health and developmental complications later on in their lives. Fortunately, advances in medicine mean even the tiniest babies can likely get bigger and stronger in neonatal intensive care units (NICU). 

A baby born during very preterm has around 80 to 90 percent chances of survival as shown in studies by the University of Utah. This is made possible by their vital organs like the heart and lungs which are developed to the extent of being able to support the babies’ lives outside the womb. Research indicates that babies born between 30 and 32 weeks, while still considered preterm, have at least a 99 percent chance of survival. They also have a very low risk of health and development complications later on. The 34 to 36 weeks category called the “late preterm” is the most common kind with nearly a 100 percent survival chance. 

2. Birth weight 

Birth weight is one of the most important predictors of mortality, correctly predicting mortality in 82.9% of premature birth cases. A Low Birth Weight (LBW) baby i.e. a baby weighing less than 5 ounces right after birth already require some special care and preterm birth further complicates the situation. Since a preterm baby doesn’t get enough time to fully develop inside the mother’s body, being underweight is one of their most common characteristics. Preterm LBW babies are at reduced odds of survival and a higher risk of disabilities and health problems. 

3. Sex 

Premature baby girls have a higher chance of survival than male babies owing to their biological buildups such as genes and hormones. For instance, estrogens strengthen the body’s immune defences and help the body sustain itself in the new environment. 

4. Race/ Ethnicity

Asian and African premature babies have a better survival rate as compared to their white counterparts according to this report of The Washington Times based on a study by the University of Florida. 

5. Preterm Birth History 

Singleton preterm births are more likely to be viable than multiples.

The footnote is that medical advances are being made in caring for premature babies which means better outcomes and more peace of mind for parents. While every week in the womb gives us more assurance for a healthy baby, know that chances for your preemie’s survival are increasing every day with medical developments. However, we cannot shy away from the fact that premature babies have a heightened chance of developing health issues ranging from short-term complications to long-term diseases. The only way we can prepare ourselves is by being educated. Read ahead to know about the potential health issues a premature baby may have to face. 

Potential Health Problems In Premature Babies

While not all premature babies experience complications, being born too early can cause short-term and long-term health problems. With that being said, it is also important to remember that the factors that affect the survival of a preemie also impact their overall health status for the initial weeks or years that follow. 

I. Short-Term Health Issues (Life-threatening)

1. Respiratory issues due to an immature respiratory system. 
2. Intraventricular haemorrhage (Internal brain bleeding).
3. Hypotension (Low blood pressure).
4. Hypothermia (Abnormally low body temperature).
5. Hypoglycemia (Low blood sugar).
6. Immature gastrointestinal system leading to conditions like intestinal inflammation.
7. Anaemia.
8. Blood infection.
9. New-born jaundice. 
10. Immune system issues that make preemies more susceptible to infections.

II. Long-Term 

1. Disorder of movement, muscle tone or posture caused by infection, inadequate blood flow or injury to the newborn’s underdeveloped brain. 
2. Slow cognition leads to learning disabilities. 
3. Impaired vision and even partial blindness in some cases.
4.  Increased risk of some degree of hearing issues or complete hearing loss. 
5. Dental problems such as delayed tooth eruption, tooth discolouration and improperly aligned teeth.
6. Behavioural or psychological problems such as ADHD. 
7. Developmental delays. 

Now it is safe to say that we are aware of the health issues our preemies may have to fight against. But what about the mother? Does her body also suffer the consequences of this untimely procedure? How does it adjust to the changes? What about the psychological self? How does deal with the tornado of emotions that surrounds her? Continue reading this article where we get to all these apprehensions. 

Mothers & Premature Births 

As important as it is to care for your baby, its health status may put you in a helpless situation. On top of all the worry about its physical condition, you may miss the experience of holding, breastfeeding, and bonding with your body as you would have hoped or planned. We can imagine how heart-wrenching this can be but know you’re not alone. As aforementioned, new research, every day is taking us closer to our preemies, quite literally. For instance, this 2021 report by WHO suggests that immediate Kangaroo mother care, which involves skin-to-skin contact and exclusive breastfeeding, significantly improves a premature baby’s chances of survival. This means that you will have the opportunity to spend time with your baby and play a pivotal role in helping them sustain the consequences of early birth. 

However, the emotional trauma of this unsettling experience can lead to various mental health conditions like PTSD, anxiety and postpartum depression. Furthermore, you may be ready to return home before your newborn is, which can be difficult to accept, but trust the doctors and remember that your baby is in safe hands. You can use your time away from the hospital to get some needed rest and prepare your home and family for your baby’s homecoming. Once your baby will be home, you can spend ample time with them. Cuddle with them or coddle them, they’re yours and will be so.