Premature birth complications
Babies born before
the 37th week of pregnancy are considered premature. Mothers who give birth
prematurely are often scared and nervous. Premature newborns are at increased
risk for one or more complications.
Most common complications of premature birth
The risk of
complications increases the earlier the baby is born.
Below is a list of
the most common complications that a premature newborn may experience:
Immature lungs. In most children, the lungs matured at 36 weeks of
gestation. However, since children develop at different rates, there are
exceptions to this rule. If the mother and her doctor know that the baby may be
born prematurely, an amniocentesis may be done to check the level of lung
maturity. In some cases, before delivery, the baby is given a steroid injection
to speed up the development of the lungs. The main problem in preterm birth is
the development of the lungs of the newborn.
Immature lungs are
associated with the following complications:
- Respiratory distress
syndrome causes hard,
irregular breathing and difficulty due to the lack of a specific agent
(surfactant) in the lungs that helps prevent lung collapse. Treatment includes
one or more of the following: supplemental oxygen (through an oxygen cap), use
of a respirator (ventilator), continuous positive airway pressure, endotracheal
intubation, and, in severe cases, doses of surfactant.
- Transient tachypnea is fast, shallow breathing. It can occur in
both premature and full-term babies. Recovery usually takes three days or less.
Until the newborn recovers, feeding may be changed and, in some cases,
intravenous feeding may be given. Usually no further treatment is needed.
- Bronchopulmonary dysplasia occurs when a child's lungs show signs of
deterioration. Unfortunately, when premature babies are put on ventilators
(also called respirators), their lungs are still immature and sometimes cannot
withstand the constant pressure of the ventilator.
Premature babies who are on mechanical ventilation for more than twenty-eight days are at risk of developing bronchopulmonary dysplasia. Premature babies can recover from this condition, but some take longer to recover than others.
- Pneumonia. Complications from premature breathing
problems can lead to pneumonia. Pneumonia is an infection of the area of the
lung involved in the exchange of carbon dioxide and oxygen. This causes
inflammation, which reduces the amount of space available for air exchange.
This can result in insufficient oxygen for the baby. Treatment may include
antibiotics, supplemental oxygen, and intubation. If left untreated, it can
turn into a life-threatening infection or lead to sepsis or meningitis.
Apnea and bradycardia - Apnea is the absence of breathing. In the neonatal
intensive care unit, an alarm is triggered if a newborn develops irregular
breathing with pauses of more than 10-15 seconds. Bradycardia is a decrease in
heart rate.
An alarm will also be
triggered if the newborn's heart rate drops below 100 beats per minute. Usually,
a light pat or simple back rub will help remind the premature baby to breathe
and also increase the heart rate.
Infection. A premature baby may not be able to fight off some
infections. For their own protection, the baby is placed in an incubator to
provide protection from these infections.
Jaundice. It
is a yellowish skin color caused by a buildup
of a substance called bilirubin in the blood. Treatment includes placement
under a bilirubin lamp. The treatment is called phototherapy. The process can
take anywhere from a week to 10 days.
Intraventricular hemorrhage. Babies born before 34 weeks have an increased risk of
cerebral hemorrhage because the immature blood vessels may not be able to
tolerate the changes in circulation that occurred during childbirth. This can
lead to future complications such as cerebral palsy, mental retardation and
learning difficulties. Intracranial hemorrhage occurs in about 1/3 of children
born at 24-26 weeks of gestation.
If a preterm birth is
identified and is imminent, the mother may be given medication to help reduce
the risk of a serious intracranial hemorrhage in the newborn.
Inability to maintain body heat. A premature baby is born with low fat and
immature skin, making it difficult to maintain body heat. Treatment includes
incubators to provide warmth.
Immature gastrointestinal tract and digestive system. Premature newborns are born with a
gastrointestinal tract that is too immature to effectively absorb nutrients. In
such cases, they receive their original nutrients intravenously. This is called
total parenteral nutrition. After a few days, newborns can be fed breast milk
or formula through a tube, as they may not yet be able to swallow or breastfeed
on their own.
Anemia.
This is a disease caused by an abnormally low level of red blood cells. Red
blood cells are important because they carry a substance called hemoglobin that
carries oxygen. Most newborns should have a red blood cell count above 15
grams. However, premature babies are at high risk of having lower levels. If
the anemia is severe, treatment may include a red blood cell transfusion to the
newborn.
Patent
Ductus Arteriosus.
This is a heart condition that causes difficulty breathing after childbirth due
to an open blood vessel called the ductus arteriosus. During fetal development,
the ductus arteriosus opens to allow blood to drain from the lungs into the
aorta. The fetus produces a chemical compound called prostaglandin E, which
maintains blood flow by keeping the ductus arteriosus open.
Eventually,
prostaglandin E levels drop, causing the ductus arteriosus to close, allowing
the baby's lungs to receive the blood they need to function properly after
birth. In preterm birth, prostaglandin E may remain at the same level, causing
a patent ductus arteriosus. Treatment includes drugs that stop or slow down the
production of prostaglandin E.
Retinopathy of prematurity. It is an eye disease that can potentially lead to
blindness. It affects most premature babies between 24 and 26 weeks of
gestation, but rarely affects them after 33 to 34 weeks of gestation. There are
many different stages of this condition, and the treatment prescribed will
depend on its severity. Treatment may include laser surgery or cryosurgery.
Necrotizing enterocolitis. This condition occurs when a part of the intestine of a
newborn develops poor blood flow, which can lead to infection of the intestinal
wall. Treatment includes intravenous nutrition and antibiotics. Only in severe
cases is surgery deemed necessary.
Sepsis. It is a disease in which bacteria enter the bloodstream. Sepsis often leads to lung infection and can lead to pneumonia. Treatment includes antibiotics.