Symptoms and treatment of Preterm birth

Description

A premature birth means that a baby is born prematurely. The birth takes place before the 37th week of pregnancy. A typical pregnancy lasts about 40 weeks.

Premature babies often have serious health problems, especially when they are born very early. These problems tend to vary. But before the baby is born, the greater the risk of health problems.

A newborn can be:

To late preterm infants, born between 34 and 36 completed weeks of pregnancy.
Moderately preterm, born between 32 and 34 weeks of pregnancy.
Very preterm, born between 28 and 32 weeks of pregnancy.
Extremely premature infants, born before 28 weeks of pregnancy.

The majority of preterm births occur in the late preterm stage.

Symptoms

Your baby may have very mild symptoms of premature birth, or more serious health problems.

Some signs of having been born too early include:

Small in size, with a large head compared to the body.
The features that are more and less rounded than a full-term baby of features, due to the lack of cells that store fat.
The fine hair that covers a large part of the body.
Lower the temperature of the body, primarily right after birth in the delivery room.
Difficulty breathing.
Feeding problems.

The following tables show the median birth weight, length and head circumference of the preterm infants at different gestational ages for each sex.

Special attention

If you give birth to a premature baby, the baby will need to stay in a special nursery unit in the hospital. Some babies need to spend time in a unit that is in charge of them and close to the slopes of your health, day and night. This is called a neonatal intensive care unit (NICU).

A step down from the NICU is an intermediate care nursery, providing less intensive care. Special nursery units are staffed with health care providers and a team that is trained to help premature babies.

Your baby may need extra help for the food and the adaptation to the right after the delivery. Your health care team can help you understand what is needed and what is your baby's care plan will be. Feel free to ask questions.

Risk factors

Often, the exact cause of preterm birth is not clear. But some things can increase the risk.

Some risk factors linked to the past and present of pregnancies are:

Pregnancy of twins, triplets or other multiples.
A span of less than six months between pregnancies. It is ideal to wait for 18 to 24 months between pregnancies.
Treatments to help you get pregnant, call of assisted reproduction, including in vitro fertilization.
More of a miscarriage or abortion.
A premature son.

Some health problems can increase the risk of preterm birth, such as:

Problems with the uterus, cervix or placenta.
Some infections, primarily those of the amniotic fluid and of the lower genital tract.
Course of health problems such as high blood pressure and diabetes.
Injuries or trauma in the body.

Lifestyle choices can also increase the risk of a premature pregnancy, such as:

Cigarette smoking, taking illegal drugs or drink alcohol often or very while you are pregnant.
Being underweight or overweight before pregnancy.
To become pregnant before the age of 17 or after age 35.
Go through stressful life events, such as the death of a loved one or domestic violence.

For reasons unknown, Black and indigenous people in the united States are more likely to have a preterm birth than women of other races. But premature birth can happen to anyone. In fact, many preterm births have no known risk factors.

Complications

Not all premature babies have health complications. But being born too early can cause short-term and long-term health problems. In general, before the baby is born, the greater the risk of complications. Birth weight plays a key role too.

Some problems may be apparent at birth. Others may not appear until later.

Short-term complications

In the first few weeks, complications of preterm birth may include:

Breathing problems.A premature baby may have trouble breathing due to being born with the lungs are not fully developed. If the baby's lungs, the lack of a substance that allows the lungs to expand, the baby may have problems getting enough air. This is a treatable problem called respiratory distress syndrome. It is common for premature babies to have pauses in your breathing is called apnea. Most children will outgrow sleep by the time they go home from the hospital. Some premature babies get a less common type of lung disorder called bronchopulmonary dysplasia. They need oxygen for a couple of weeks or months, but they tend to overcome this problem.
The problems of the heart. Some of the heart problems that preterm babies have are patent ductus arteriosus (PDA) and low blood pressure. The PDA is an opening between two major blood vessels, the aorta and the pulmonary artery. This heart defect is often closes on its own. But without treatment it can lead to problems such as heart failure. That is when the heart can't pump blood as well as it should. Low blood pressure may need to be treated with intravenous fluids, medications, and sometimes blood transfusions.
Brain problems. Before the baby is born, the greater the risk of bleeding in the brain. This is called an intraventricular hemorrhage. The majority of bleeding are mild and resolve with little short-term impact. But some babies may have a higher bleeding in the brain that cause a permanent brain injury.
Temperature Control problems.Premature babies can lose body heat quickly. They do not have the stored body fat from a baby to term. And they can't produce enough heat to counteract what is lost through the surface of their bodies. If the body temperature drops too low, which can lead to a dangerous problem called hypothermia. Hypothermia in a premature baby can cause breathing problems and low blood sugar levels. A premature baby can also use all the energy obtained from food just to stay warm. That's why more small premature babies need extra heat from a heater or an incubator in a first time.
The digestive problems. Premature babies are more likely to have digestive systems that are not fully developed. This can lead to problems such as necrotizing enterocolitis (NEC). With NEC , the cells lining the wall of the intestine is injured. This problem can occur in babies born prematurely after the beginning of the feeding. Premature babies who receive only breast milk have a much lower risk of getting NEC .
Blood problems. Premature babies are at risk of blood problems such as anemia and newborn jaundice. With anemia, the body does not have enough red blood cells. All newborns have a slow decrease in the count of red blood cells during the first months of life. But the drop can be higher in premature infants. With newborn jaundice, the skin and eyes look yellow. This occurs because the baby's blood contains a lot of a yellow-substance of the liver or red blood cells. This substance called bilirubin. Jaundice has many causes, but it is more common in premature babies.
Problems of metabolism. Premature babies often have problems with metabolism. This is the process by which the body changes food and drink into energy. Some premature babies may have a very low level of sugar in the blood. This can happen due to that premature babies often have small amounts of stored sugar in the blood than babies born at term. Premature babies are also more difficult to rotate your stored sugar in the more usable, active forms of sugar in the blood.
Immune system problems. It is common for premature babies have an immune system that are not fully developed. This can lead to an increased risk of disease. An infection in a premature baby may spread rapidly by the bloodstream and cause a life-threatening condition called sepsis.

Breathing problems. A premature baby may have trouble breathing due to being born with the lungs are not fully developed. If the baby's lungs, the lack of a substance that allows the lungs to expand, the baby may have problems getting enough air. This is a treatable problem called respiratory distress syndrome.

It is common for premature babies to have pauses in your breathing is called apnea. Most children will outgrow sleep by the time they go home from the hospital. Some premature babies get a less common type of lung disorder called bronchopulmonary dysplasia. They need oxygen for a couple of weeks or months, but they tend to overcome this problem.

Temperature Control problems. Premature babies can lose body heat quickly. They do not have the stored body fat from a baby to term. And they can't produce enough heat to counteract what is lost through the surface of their bodies. If the body temperature drops too low, which can lead to a dangerous problem called hypothermia.

Hypothermia in a premature baby can cause breathing problems and low blood sugar levels. A premature baby can also use all the energy obtained from food just to stay warm. That's why more small premature babies need extra heat from a heater or an incubator in a first time.

The long-term complications

In the long-term, premature birth can lead to health problems such as:

The Cerebral palsy. This group of disorders that may cause problems with movement, muscle tone or posture. It may be due to an infection or poor blood circulation. It may also come from an injury to the brain of the newborn, because it is early during pregnancy or while the baby is still young.
Learning problems. Premature babies are more likely to lag behind the babies born at term in different milestones. A school-age child who was born too soon could be more likely to have learning problems.
Vision problems. Premature babies may get an eye disease called retinopathy of prematurity. This occurs when the blood vessels swell and grow too large in the perception of light in the tissue of the posterior part of the eye called the retina. Sometimes these covered glasses slowly the scar of the retina and pull it out of place. When the retina separates from the back of the eye, is called retinal detachment. Without treatment, it can damage vision and cause blindness.
Problems of the hearing. Premature babies have a higher risk of losing some of your hearing. All babies should have their hearing checked before going home from the hospital.
Dental problems. Premature babies are more likely than full-term babies to have defects with the hard outer covering of teeth, called enamel. Babies who are born very or extremely early, they may also be more likely to have teeth that take the most time to develop.
Behavior and mental health problems. Children born prematurely are more likely than children born full-term to have certain mental health problems, as well as delays in the development.
Ongoing health issues. Premature babies are more likely to have long-term health problems than full-term babies. Disease, asthma, and feeding problems are more likely to develop or stay. Premature babies are also at higher risk of sudden infant death syndrome (SIDS). That is when a baby dies for no apparent reason, often during sleep.

Prevention

The exact cause of preterm birth is often unknown. But there are some things you can do to help reduce the risk of premature birth, including:

Taking progesterone supplements. Progesterone is a hormone that plays a role in the pregnancy. A lab-made version of that might be able to reduce the risk of premature birth if you have had a premature baby before. It can also reduce the risk of premature birth if you have a short cervix. The cervix is the lower end of the uterus that opens during labor so that a baby can be born.
Cervical cerclage.This is a surgery that is performed during pregnancy. Your doctor may suggest that if you have a short cervix, and you have had a prior preterm delivery. During this procedure, the cervix is stitched closed with a strong suture. This may give the uterus of additional support. The suture is removed when it is time to have the baby. Ask your doctor if you need to stay away from strenuous activity for the rest of your pregnancy.

Cervical cerclage. This is a surgery that is performed during pregnancy. Your doctor may suggest that if you have a short cervix, and you have had a prior preterm delivery.

During this procedure, the cervix is stitched closed with a strong suture. This may give the uterus of additional support. The suture is removed when it is time to have the baby. Ask your doctor if you need to stay away from strenuous activity for the rest of your pregnancy.

One thing that does not help to prevent preterm birth is stay in bed. Bed rest can increase the risk of blood clots, bones weaker and less muscle strength. Could even make the premature birth more likely.

Diagnosis

A premature baby in the NICU may need to have a lot of tests. Some tests are in progress. Other tests may be done only if the staff of the NICU thinks that the baby may have a particular health problem.

The evidence of their premature baby may need include:

Breathing and heart rate control. The baby's breathing and heart rate are monitored on an ongoing basis. Blood pressure readings are often performed too.
Fluid input and output measurement. The NICU team tracks the amount of fluid that your baby is feeding through and through a vein. The computer also controls the amount of fluid your baby lost through wet or dirty diapers.
Blood tests.Blood samples are taken by clicking on the heel or the placement of a needle into a vein. These tests are going to theNICUstaff a closer look at the levels of important substances in the blood of your baby, such as calcium and blood sugar. A blood sample can also be selected to search for signs of problems such as anemia or disease. Your baby's health care provider theNICUstaff take many blood samples. If so, the staff can insert a thin tube into a vein in the stump of the baby's umbilical cord. In this way, the staff do not have to stick your baby with a needle each time the blood is needed.
Echocardiography. This imaging test is an ultrasound of the heart. Checks to see if there are any problems with the manner in which the heart works. Use sound waves to make images on a display screen.
Ultrasound. This imaging test can be done to check the brain for bleeding or fluid accumulation. Or it can be used for the verification of the organs in the stomach area, due to problems with the digestive tract, the liver or the kidneys.
Examination of the eyes. An eye doctor called an ophthalmologist can check your baby's eyes and the vision to look for problems with the retina.

Blood tests. Blood samples are taken by clicking on the heel or the placement of a needle into a vein. These tests allow the staff of the NICU to see up close the levels of important substances in the blood of your baby, such as calcium and blood sugar. A blood sample can also be selected to search for signs of problems such as anemia or disease.

Your baby's health care provider, the NICU staff to take many blood samples. If so, the staff can insert a thin tube into a vein in the stump of the baby's umbilical cord. In this way, the staff do not have to stick your baby with a needle each time the blood is needed.

More tests may be needed if your baby has other health problems.

Treatment

The neonatal intensive care unit (NICU) or special care nursery close track of your premature baby's health.

Supportive care

This type of care for your baby can include:

Are placed in an incubator. The incubator is an enclosed plastic bassinet that your baby will probably stay in. It's kept warm to help your baby stay in a regular body temperature. Later, NICU staff can show you a way to hold your baby with the direct skin-to-skin. This is known as "kangaroo care."
The follow-up of the baby's vital signs. The sensors can be taped to the body of your baby for the monitoring of the blood pressure, heart rate, breathing and temperature. A machine called a ventilator, or a device called a CPAP can be used to help your baby to breathe.
To have a feeding tube. At first, your baby may receive fluids and nutrients through a tube in a vein. Breast milk can be given later through a tube that passes through the nose of his baby and in the baby's stomach. When your baby is strong enough to suck, breast-feeding or bottle-feeding can often be made.
Get the sufficient amount of liquid. Your baby needs a certain amount of fluid each day. The exact amount depends on the age of the baby and health. The NICU team will closely track of fluid, sodium and potassium levels to make sure that your baby's fluid levels stay in your destination. If liquids are required, they will be delivered through a tube into a vein.
Spending time under the bilirubin lights. To treat jaundice child, your baby may be placed under a set of special lights. These lights help your baby out of the system to break down excess bilirubin. This is a yellow-colored substance that accumulates in the body if the liver can't process it all. Your baby is going to wear a protective eye mask, while under the lights to rest more easily.
Receive blood from a donor. Some premature babies need blood transfusions. This may be due to certain health issues, or because many of the blood samples have been taken for testing.

Drugs

Medicines may be given to your baby for different reasons. For example, some medications help to the lungs and the heart work better. Depending on your baby's health, the medications you receive may include:

Surfactant, which is used to treat the respiratory distress syndrome.
Fine mist or drugs that are administered in a vein to strengthen the breathing and heart rate.
Antibiotics for a disease caused by a bacterium, or if there is a risk of a disease of that kind.
Diuretics, which cause the baby to pee more to manage excess fluid.
An injection of a medication into the eye to stop the growth of new blood vessels, which could cause the disease of the eyes with retinopathy.
The medicine that helps to close the heart defect called patent ductus arteriosus.

Surgery

Sometimes surgery is needed to treat a premature baby of the health problems. Talk with your baby's health care team to understand that complications may lead to surgery. Learn about the types of surgery that may be necessary to treat these problems.

Take your baby home

The following signs means that your baby is ready to go home:

You can breathe without help.
Has a stable body temperature.
Can breast-feeding or bottle-feeding.
Is gaining weight over time.
Is free of major health problems.

The hospital can let the baby to go home before you meet one of these requirements. But the baby's medical team and the family first need to establish and agree on a plan for the care of the home and follow-up health care.

Your baby's health care team will help you to learn how to take care of your baby at home. Before your baby can leave the hospital, your baby's nurse or a hospital discharge planner can ask questions about:

Where you live and who to live with.
Other children in the home.
Adult family and friends who may help you to take care of your baby.
The baby's primary care provider will be.

Lifestyle and home remedies

The idea of bringing your baby home from the hospital, it could make you feel relieved, excited and nervous. You can do some things ahead of time to prepare for the life in the home:

Understand how to take care of your baby.Before you leave the hospital, to take a course in CPR (cardiopulmonary resuscitation). This can save the lives of infants who stop breathing. Ask your baby's health care team about any questions you may have, and take notes. Make sure that you are comfortable with the care of your baby. This is very important if you need to use the health of the monitors or to give your baby medication, oxygen, or other treatments. Ask what symptoms to call your doctor about, such as breathing or feeding problems.
Talk about the food. Ask the health care team of your baby's need for an extra nutrition. The team might suggest that the use of products such as the breast milk to strengthen the supplements or premature infants. Keep in mind that premature babies often eat less and may need to be fed more often than full-term babies. Know how much and how often your baby should be eating.
Limit contact with other people. Premature babies are more likely to contract serious diseases than other newborns. Try to keep your baby away from crowded places as much as you can. And make sure that everyone who comes into contact with your baby is washed your hands first. Ask people who are sick to put off his visit until they are well.
Protect your baby fromRSV.Premature babies have a higher risk of getting a serious disease calledRSVinfection. This disease is caused by a virus. Affects the lungs and other organs involved in breathing. There are a couple of options to protect premature babies severeRSVinfection. One is anRSVvaccine for pregnant people, which helps to protect babies from birth until 6 months of age. The other is an antibody product given to the baby. This product is called nirsevimab (Beyfortus). Rarely, when nirsevimab is not available or that a child is not eligible for it, another antibody product called palivizumab may be given.
Follow a suggested schedule for check-ups. Talk about your baby needs for the future of the health screenings with your baby's care provider, and any specialist. At the beginning, your baby may need to see a primary care provider every week or two. That way the baby's growth, the needs of health and care can be closely observed.
Get your baby vaccinated.Vaccines help to protect people from dangerous diseases. It is suggested that the vaccines given to premature babies who are in stable health based on their age. Your baby's care team can talk with you about a program for when your baby should receive each vaccine. The delays in this program are common. Working with your baby's care provider to ensure that your baby receives all the vaccines in the calendar. Also make sure that other members of the family in your home are up to date on their vaccines, including the vaccines for the flu and COVID-19. Family members and caregivers should also consult with their health care providers to find out if they are up to date on their whooping cough vaccine against whooping cough. If you are pregnant, make sure you are up to date in this shot too.
Note delays in the development. During the next few months, your baby care doctor can see by the signs that the baby is taking more time than usual to reach key milestones. Babies who are at risk for delays or disabilities may need more tests. You may be referred to the services and support systems that can help, and called the early intervention services. The rules that determine who can use these services vary depending on where you live.

Understand how to take care of your baby. Before you leave the hospital, to take a course in CPR (cardiopulmonary resuscitation). This can save the lives of infants who stop breathing. Ask your baby's health care team about any questions you may have, and take notes.

Make sure that you are comfortable with the care of your baby. This is very important if you need to use the health of the monitors or to give your baby medication, oxygen, or other treatments. Ask what symptoms to call your doctor about, such as breathing or feeding problems.

Protect your baby fromRSV. Premature babies have a higher risk of getting a serious illness called RSV infection. This disease is caused by a virus. Affects the lungs and other organs involved in breathing.

There are a couple of options to protect premature infants from severe RSV infection. One is an RSV vaccine for pregnant people, which helps to protect babies from birth until 6 months of age. The other is an antibody product given to the baby. This product is called nirsevimab (Beyfortus). Rarely, when nirsevimab is not available or that a child is not eligible for it, another antibody product called palivizumab may be given.

Get your baby vaccinated. Vaccines help to protect people from dangerous diseases. It is suggested that the vaccines given to premature babies who are in stable health based on their age. Your baby's care team can talk with you about a program for when your baby should receive each vaccine. The delays in this program are common. Working with your baby's care provider to ensure that your baby receives all the vaccines in the calendar.

Also make sure that other members of the family in your home are up to date on their vaccines, including the vaccines for the flu and COVID-19. Family members and caregivers should also consult with their health care providers to find out if they are up to date on their whooping cough vaccine against whooping cough. If you are pregnant, make sure you are up to date in this shot too.

Coping and support

Take care of a premature baby can be very stressful. You may be concerned about their baby's health. You may also feel angry, guilty, or overwhelmed.

Some of these tips can help during this difficult time:

Learn all you can about your baby's health. Talk with your baby's health care providers. Brochures, books and web sites that you trust for more information about the care of their premature baby.
Take care of yourself. Get as much rest as you can. Eating healthy foods also. You'll feel stronger and more capable of taking care of your baby.
To increase your milk production. The use of a breast pump until your baby is able to breastfeed. Ask the staff of the hospital in search of help. We can show you how to use a breast pump and find the supplies that you will need to store the milk.
Accept help from others. Let friends and family help you. They could care for her other children, prepare food, clean the house or run errands. This helps you to save your energy for your baby.
Keep a journal. Make a note of the details of the development of the baby, along with your own thoughts and feelings. It is possible that you want to include photos of your baby. That way you can see how much your child changes from week to week.
Find good listeners for the support. Talk with your partner or spouse, friends, family, or your baby's caregivers. The NICU social worker can often be useful. If you are interested, your baby, the doctors may be able to suggest a support group in your area or online. Many parents find it very helpful to talk with other parents who care for a premature baby.

Take care of a premature baby is a great challenge. Take it one day at a time. Despite the concerns and setbacks, celebrate your premature baby of the force and the ability to adapt. We appreciate the time that you can spend to get to know your child.

Preparing for your appointment

As a parent of a premature baby in the neonatal intensive care unit (NICU), you will need to speak with many providers of care for your baby. The members of the intensive care unit of the care team of your baby may include:

Neonatal nurse — A registered nurse who has special training in the care of high-risk premature infants and newborns.
Neonatal nurse practitioner — an experience of A neonatal nurse who has completed additional training to help doctors called neonatologists in the care of newborns.
Pediatrician — A doctor who treats children from birth to the end of childhood.
Neonatologist — A pediatrician is trained to treat the health problems in newborns.
Pediatric resident — A doctor who is trained to treat children.
Respiratory therapist — A supplier that assist in the care of newborns with breathing-related problems.
Pediatric surgeon — A surgeon who is qualified to do the surgery for newborns and children.

You can also meet with a pediatric social worker. This professional can help you find the services that may be useful to you during and after your baby stay in the hospital.

Ideally, you are going to work together with your baby's care providers. Over time, they can show you how to hold, feed, and care to your baby.

What you can do

It's ok to ask the intensive care unit care team any questions you have about your baby's condition. Or you can write your questions and get answers when you're ready.

For example, you could ask:

How is the health of my baby? Has anything changed?
How does this team help my baby?
Why is going to give my baby medicine?
What types of tests does my baby need?

You can also ask how to help take care of your baby:

When can I hold my baby? Will you show me how?
When I try to breastfeed or bottle-feed my baby?
Who should I contact if I have questions about my care of the baby?
I can bring a blanket or family photos to customize my baby in the incubator?

You may have questions about bringing your baby home:

When will my baby be able to return home?
What do I need to know about the care of my baby once we are at home?
How often do we have to go back to the hospital for follow-up visits?

During your baby in the NICU , feel free to ask the staff how you can participate more in the care of your baby. It can give you confidence as a new parent. You can also make life easier once you bring home your child.