Premature Birth

Premature Birth

Premature births are those babies that are born less than 37 weeks along. According to the March of Dimes, about 12 percent of babies in the United States are born preterm. Approximately 84 percent are born between 32 and 36 weeks of gestation. Roughly 10 percent are born between 28 and 31 weeks and about 6 percent are born at less than 28 weeks of gestation. Prematurity is the leading cause of death in newborns during the first month of life.

Why does Premature Birth Happen?

There are many risk factors that may help explain why women go into labor early. However, nearly half of all premature births occur for unknown reasons.

Here are some factors that can put you at risk:

• Delivering a previous premature baby
• Having an infection such as a urinary tract infection, beta strep, STD, or bladder infection
• Having uterine or cervical complications
• Being younger than 17 or older than 35
• Being African-American and/or economically poor
• Receiving late or no prenatal care
• Smoking, drinking alcohol, or using illegal drugs
• Being a victim of domestic violence or having little or no social support
• Being stressed
• Working long hours or performing a job that requires long periods of standing or walking
• Being obese or underweight before your pregnancy
• Carrying multiple babies or carrying a baby with a certain type of birth defect
• Being diagnosed with high blood pressure or clotting disorders
• Undergoing in vitro fertilization
• Waiting a short amount of time between pregnancies (less than 6-9 months)

You also may also be induced before your baby is at full-term if your health or your baby’s health is in jeopardy. Health complications that may require an early induction include:

• Preeclampsia
• Pregnancy-induced hypertension
• Maternal diabetes
• Heart disease
• Placental abruption (when the placenta detaches early from the uterine wall)

Can my Care Provider Stop Me from Going into Labor Early?

Your care provider will try very hard to stop preterm labor. However, if your membranes rupture, he/she may have no choice but to deliver your baby.

It is vital if you are going into preterm labor that it is caught quickly. If you experience any labor symptoms before 37 weeks you need to contact your care provider immediately.

If your cervix is dilating or you are having ‘real contractions’ and not Braxton Hick contractions, your care provider may put you on bed rest. This can mean anything from not being allowed to get out of bed to being able to move around your house and sit up in bed or on the couch.

Your care provider may also use certain medicines to halt labor. Terbutaline is used to relax the uterus. Terbutaline may be given to you as a shot when if you come into the hospital. You can also take in pill form every couple of hours in your home. If labor does not stop, your doctor may give you magnesium sulfate through an IV. Magnesium sulfate will relax all of your muscles. You will be required to stay in bed, be on a fetal monitor and have your blood pressure monitored. There is a great deal of debate about the effectiveness of magnesium sulfate. If labor cannot be halted, your doctor may give you corticosteroids to help mature your baby’s lungs.

Complications due to Prematurity

You can find more information about the complications of prematurity at March of Dimes.

• Respiratory Distress Syndrome (RDS) is a breathing difficultly many babies born before 34 weeks have. Babies with RDS may need additional oxygen and mechanical breathing assistance to help them breathe. The sickest or most premature babies may need a respirator.
• Jaundice happens when preemies' livers are too immature to process a waste called bilrubin. Though full-term babies may become slightly jaundiced, premature babies are more sensitive to the effects of excess bilrubin. Too much bilirubin can cause brain damage, though with medical technology this is usually prevented.
• Apnea occurs when babies stop breathing for 20 seconds or more. It may be accompanied by a slow heart rate. Preemies are constantly monitored for apnea. If your baby stops breathing in the NICU, the nurse will stimulate your baby to help him/her start breathing again. One of the monitors your baby may be attached to in the NICU checks for apnea.
• Intraventricular hemorrhage (IVH) is bleeding in the brain and occurs in the most premature babies. While IVH can cause brain damage, many brain bleeds resolve themselves with no or few long term complications.
• Patent ductus arteriosus (PDA) is a heart problem fairly common in premature babies. A large artery in the heart called the ductus arteriosus may not develop properly. It can lead to heart failure and lack of oxygen to the organs.
• Retinopathy of prematurity (ROP) is an abnormal growth of blood vessels in the eye. It can cause damage to the retina of the eye, vision loss, or blindness.
• Preemies are often are anemic, which means they do not have enough red blood cells. Anemic babies may develop feeding problems and can have exacerbated heart or breathing difficulties.
• Premature babies are more prone to infections and viruses. Preemies are more likely to contract pneumonia, sepsis, and meningitis.