The Early Start into Life – In Germany, about 9 percent of all born babies are born prematurely. According to the World Health Organization (WHO), the rate worldwide is 10 percent – and rising.
Table of Contents
Causes and risk factors
Physicians distinguish between moderately premature infants ( 32nd to 37th week of pregnancy ), very early births ( 28th to 31st week of gestation ) and extremely premature babies (before the 25th to 28th week of gestation ). Preemies often weigh less than 2,500 g and require intensive medical care, depending on their level of development.
The causes of premature birth can often not be identified. Usually, it is a combination of various factors such as pre-existing conditions of the mother, infections, psychosocial stress, age of the mother, particularly harmful or toxic substances or disorders in the development of the unborn child. Possible causes that can cause premature birth include:
- Vaginal infections such as chlamydia
- Pre-existing conditions of pregnant women: diabetes, hypertension, thyroid and kidney diseases
- Malformations of the uterus or placenta
- A multiple pregnancies
- Developmental disorders of the child
- Genetic abnormalities in the unborn baby
- Premature rupture of membranes
- Overweight and underweight of pregnant women
- Age of pregnant women: under 18 or over 35 years
But there are also external factors that can increase the risk of premature birth. This includes, for example, excessive consumption of nicotine and alcohol or excessive stress during pregnancy. The risk of a miscarriage can be reduced if pregnant women eat healthily and do not overload.
It is also essential to have regular check-ups with your doctor during check-ups. Signs of impending premature birth may be early labor that occurs well before the expected date of birth.
With regular contractions (up to three times an hour) and back pain, you should immediately go to the hospital. But also bleeding and an open cervix can indicate a premature birth. Your doctor will decide what to do in this situation: Medication or strict bed rest may delay imminent premature birth.
Cesarean section or natural birth?
Whether you want to deliver your baby via Caesarean section or the natural way in the case of an imminent premature birth depends on the maturity and the general condition of your baby. If the doctors have no objections and there is no danger to mother and child, the premature baby can be spontaneously delivered.
Cesarean section is the only option for extremely premature babies due to their low birth weight and lack of organ maturity. Immediately after birth, the preemies care for intensive care.
Medical care of premature babies
Babies born before the 37th week of gestation need intensive medical care after delivery. The farther the child is from the estimated date of birth, the less mature are organs such as lungs and kidneys.
After birth, the preemies are placed in an incubator or a heated bed. Since they can not regulate their body temperature, the nursery ensures the correct ambient temperature.
Respiration and heartbeat of the premature baby are monitored around the clock.
Extremely premature babies often need artificial respiration and nasogastric feeding. At least as important as the medical care of preemies is the physical contact with mother or father. Once the children are stable enough, they are placed naked on the bare-chested parent’s breast for one or more hours each day using the so-called kangaroo method.
Warmly covered by towels and blankets, the baby can hear mom’s or dad’s heartbeat. The parent-child attachment, which is so important for the baby, can be built up in this way, in addition to stimulating the baby’s senses.
As a rule, preterm infants remain in the incubator until the 34th week of gestation or between 1400 g and 1800 g. After that, the premature babies are placed in a warm bed, depending on individual development. For premature babies to be able to go home to their parents finally, they should have reached a weight of at least 2,500 g.
The decisive factor is whether the baby’s breathing and circulation are stable and whether it can regulate its body temperature independently. Also, the child should be able to drink at the breast or a milk bottle . Close contact with the midwife, the pediatrician and possibly a nursing service gives parents security, especially at first with their preemies.
Consequences and late effects of a premature birth
Due to the significant advances in intensive care medicine, even babies with a birth weight of less than 1000 g have a chance to survive. The too early childbirth may have consequences for the child’s development:
Partial significant physical and mental impairments, as well as an increased susceptibility for infections and asthma, can be consequences of premature birth. In preemies, for example, behavioral problems, learning disabilities, and ADHD are more often observed in kindergarten and school than in mature children. Motor damage is also possible.
On the other hand, premature babies born after the 32nd week of pregnancy have a good chance of normal development. Of course, not all of these long-term consequences for preterm infants may occur, but there is an increased risk.
Precisely for this reason, it is so important to closely monitor the development of premature babies over the years to be able to react appropriately to possible long-term consequences. With therapies tailored exactly to the child, impairments can be partially compensated.
Help for preemie parents
For parents, the birth of a premature baby is an extremely exceptional situation: mother and father commute between the hospital and their home in the constant fear that their baby might be worse off. For weeks or even months, they experience an alternation of feelings between hope, fear and joy.
Also, there is often the profession of family man and siblings who need to be cared for. This stressful time does not leave its mark on the parents. If the premature baby is finally at home, the daily routine with the baby has to be reorganized and first uncertainties overcome.
To relieve the mother, for example, you can hire domestic help. If a medical certificate is available, the costs will be covered by the health insurance companies. Contact with like-minded preemie parents can be of great help to many sufferers. They can exchange ideas, encourage each other and share experiences with the premature babies.
TIPS FROM GYNECOLOGIST DR.VERENA BREITENBACH
- A regular pH test of the vagina can lower the risk.
- Homeopathic remedies may help in case of imminent premature birth.
- Abstain from nicotine.