Preterm or Premature infants are infants born less than 37 weeks of pregnancy.
World prematurity day is observed on17th November each year to raise awareness of Preterm birth and the concerns of preterm babies and their families worldwide. Approximately 15 million babies are born preterm each year, which is 10% of all babies born worldwide.
Preterm birth is a very serious health problem. It is the leading cause of death in children under 5 years of age worldwide. The babies who survive may face long-term health problems that affect the brain, lungs, hearing or vision.
They often need extra or intensive medical care and support while their organs continue to develop to a point where they can survive without specialist help.
A baby born at 36 weeks will probably be a little slow to feed. A baby born before 33 weeks will have more serious problems including possibly immature lungs. Birth before 28 weeks results in very significant problems but the survival rate is quite remarkable nowadays.
These babies may face the following problems
- Decreased body temperature, requiring the babies to be kept under Warmer.
- Decreased blood sugar, blood calcium level. Both can cause fit that may produce long-term brain damage.
- Respiratory distress requiring long-term oxygen inhalation and sometimes use of ventilator machine to help the baby breathe. Babies may need a medicine called Surfactant to be infiltrated in the lungs.
- These babies may also stop breathing from time to time requiring constant monitoring
- These babies are more susceptible to develop jaundice
- They are prone to get infected and develop a condition called Septicemia requiring an antibiotic injection in veins.
- When feed is started for these babies, they may develop a condition where the intestine may become inflamed and may develop necrosis.
- Due to fragile blood vessels, they are susceptible to brain hemorrhage and long-term neurological problems
- They may develop a problem in Retina called Retinopathy Of Prematurity (ROP) and even this may result in blindness. So timely intervention is needed including Laser Surgery.
- These babies are prone to develop a cardiac problem where a tube connecting 2 blood vessels leaving the heart remains open.
All these problems are treated by Neonatologists in NICU (Neonatal Intensive care Unit) or SCBU (Special Care Baby Unit).
After discharging these babies need to be followed up at High-Risk Clinic where a team of doctors monitors babies feeding, growth, development, vision, and hearing.
Recently our institute discharged a baby delivered at 28 weeks of pregnancy with a birth weight of approximately 800 grams. The baby was at NICU for two and half months after birth developing several complications of prematurity including Respiratory Distress, septicemia, decreased sugar and calcium, feeding problems, jaundice. The baby had to be kept on ventilator support for about 2 months. Now the baby is fine with satisfactory development and minimal retinal problem.
Dr. Kausik Sur
Consultant – Paediatrics
Narayana Multispeciality Hospital, Howrah