Definition

A premature baby is a baby born alive before 37 weeks of gestation. The earlier a baby is born, the higher the risk of disability and mortality.

It is estimated that annually, about 15 million babies are born prematurely. Premature babies, especially those born very early, often have various health problems.

Around 1 million babies die each year due to complications from premature birth. Many premature babies suffer from disabilities, such as vision or hearing impairments and learning difficulties.

There are four categories of premature birth based on gestational age:

• Late preterm: Babies born between 34-36 weeks of gestation.
• Moderately preterm: Babies born between 32-34 weeks of gestation.
• Very preterm: Babies born between 28-32 weeks of gestation.
• Extremely preterm: Babies born before 28 weeks of gestation.

Most premature babies fall into the late preterm category.

Causes

Premature birth can be caused by many factors. Most premature births occur spontaneously without a clear cause, but some are due to specific medical conditions, such as infections or other pregnancy complications requiring immediate delivery.

Other causes of premature birth include:

• Multiple pregnancies
• Infections
• Chronic illnesses, such as diabetes and hypertension

Read more: Gestational Diabetes - Definition, Causes, Symptoms, and Management | AI Care (ai-care.id)

Risk factor

Although the specific cause of premature birth is unclear, several factors can increase a mother's risk of delivering prematurely, including:

• Having a history of premature birth in previous pregnancies
• Multiple pregnancies (twins, triplets, or more)
• Smoking and illegal drug use during pregnancy
• Short interval between pregnancies (< 18 months)
• Maternal age under 20 or over 40
• Uterine problems
• History of miscarriage or more than one abortion
• Low maternal weight before pregnancy
• Physical injuries

Symptoms

Premature babies may have mild to serious health problems. The signs of a premature baby include:

• Small size, with a relatively large head
• Fine hair (lanugo) covering much of the body
• Low body temperature
• Respiratory problems
• Difficulty feeding due to immature sucking or swallowing reflexes
• Lack of body fat, making the baby appear less plump than full-term babies

Diagnosis

Premature babies are immediately transferred to a neonatal intensive care unit (NICU). The doctor performs several examinations, and if complications are found, the doctor takes immediate action.

Some examinations that may be performed include:

• Monitoring breathing and heart rate: The baby's breathing and heart condition are closely monitored, and blood pressure is frequently checked.
• Fluid monitoring: The doctor carefully monitors fluid intake and output.
• Blood tests: Blood tests check calcium, blood sugar, and bilirubin levels. They also assess for possible infections.
• Echocardiography: This test examines the baby's heart condition and structure.
• Ultrasound: Used to check for abnormalities in the brain, digestive tract, liver, or kidneys.
• Eye examination: This checks the baby's eye health and vision.

Management

Premature babies require special care in the NICU. Some babies need care for weeks or months.

Supportive Care

• In an incubator: Keeps the baby warm.
• Monitoring vital signs: Regularly checks blood pressure, heart rate, respiratory rate, and body temperature.
• Feeding tube: Used because premature babies cannot suck or swallow well.
• Fluid management
• Phototherapy: Treats jaundice.
• Blood transfusions: If the baby has anemia, a blood transfusion may be needed.

Medications

Doctors prescribe medications based on the baby's condition, such as antibiotics for bacterial infections. Other medications may include:

• Surfactants: Treat respiratory problems.
• Diuretics: For fluid retention.
• Antibiotics: To treat or prevent bacterial infections.

Surgery

Surgery may be required for health issues, such as structural heart problems.

Complications

A fetus needs about 40 weeks in the womb to fully grow and develop. Premature birth means the fetus is underdeveloped, leading to various health problems.

Complications can include:

• Respiratory problems: Due to underdeveloped lungs.
• Heart problems: Most commonly patent ductus arteriosus (PDA) and low blood pressure (hypotension).
• Brain problems: Higher risk of brain bleeding (intraventricular hemorrhages) the earlier the baby is born.
• Temperature regulation problems: Risk of hypothermia due to rapid heat loss.
• Digestive problems: Risk of necrotizing enterocolitis (NEC), a serious condition causing bowel tissue damage.
• Blood problems: Anemia and jaundice due to low red blood cell counts and high bilirubin levels.
• Metabolic problems: Risk of hypoglycemia due to low blood sugar stores.
• Immune system problems: Underdeveloped immune system increases infection risk, which can lead to sepsis and death.

Premature babies have a higher risk of developmental issues and health problems later in life, such as:

• Cerebral palsy: Affects movement, muscle tone, and posture.
• Vision and hearing impairments
• Learning difficulties
• Growth problems

Read more: Cerebral Palsy Disease - Definition, Causes, Symptoms, and Management | AI Care (ai-care.id)

Prevention

There is no definitive way to prevent premature birth, but you can reduce the risk by:

• Avoiding smoking, alcohol, and illegal drugs during pregnancy
• Eating a healthy and balanced diet
• Regular prenatal check-ups
• Managing stress
• Spacing pregnancies at least 18 months apart

When to see a doctor?

Premature babies are vulnerable to various health issues. If your baby has breathing difficulties, appears yellow (jaundice), has a fever, or refuses to feed, take your baby to the nearest hospital immediately.

Looking for more information about other diseases? Click here!