17 November: World Prematurity Day
What is preterm birth?
Babies delivered alive before 37 weeks of pregnancy are considered preterm. Based on gestational age, preterm birth is divided into the following subcategories:
- Extreme prematurity (less than 28 weeks)
- Extreme preterm (28 to 32 weeks)
- Moderate-to-late preterm (32 to 37 weeks)
What are the risk factors for preterm birth?
Risk factors for preterm birth are:
diabetes, high blood pressure, multiple gestation (being pregnant with more than one baby), being either obese or underweight, vaginal infections, air pollution exposure, tobacco smoking, and psychological stress.
Why prematurity is an important concern?
Every year, an estimated 15 million babies are born prematurely. That is more than one in ten infants. A million children die each year from problems associated with premature delivery. In addition, learning difficulties, vision and hearing issues, and other disabilities are common among those who survive.
Why does preterm birth happen?
There are many causes of preterm birth. Most preterm deliveries occur spontaneously without any particular reason. However, some are brought on through early caesarean sections or labor inductions, whether for medical or non-medical reasons.
Multiple pregnancies, infections, and chronic illnesses like diabetes and high blood pressure are among the common causes of premature birth, however often there is no clear underlying reason. Additionally, there may be a hereditary component.
What are the danger signs of preterm labor?
Preterm labor, which occurs before 37 weeks of pregnancy, typically starts suddenly and without apparent cause. Like early labor, preterm labor symptoms include—
- Contractions (when the abdomen tightens like a fist) at least once every 10 minutes,
- Vaginal discharge has changed (a significant increase in the amount of discharge or leaking fluid or bleeding from the vagina)
- The sensation that the baby is pressing down on your pelvis
- Low back ache
How do we prevent preterm birth?
Some of the general measures of preventing preterm birth are:
- Avoiding alcohol, tobacco products, smoking and other substances
- Eating balanced diet
- At least 30 minutes of regular exercise
- Losing weight if obese and gaining weight if underweight
- Practicing stress relieving techniques
- Getting medical conditions under control (Diabetes, HTN)
Some of the specific measures of preventing preterm birth are:
- Regular antenatal checkups with trained health professional
- Management once preterm labor has initiated
- Prophylactic corticosteroids – to help the baby’s lungs mature
- Antibiotics for premature rupture of membranes
- Tocolytics to stop premature uterine contractions
What are the complications of Preterm birth?
Due to the incomplete development of organs, premature newborns experience problems. The more preterm a baby is, the more chances of complications, which include:
- Neurological concerns: include apnea (when the baby stops breathing because the nervous system is not mature), impaired swallowing and sucking, and brain hemorrhage.
- Complications of the digestive tract: include necrotizing enterocolitis – a condition where feeds are not tolerated causing the abdomen to distend, bleeding intestines, jaundice, hypoglycemia
- Immune system issues: Bloodstream infections (sepsis) or brain infections (meningitis)
- Difficulties with the lungs: Respiratory Distress Syndrome due to lung immaturity
- Eye problems: Retinopathy of prematurity, a condition where the retina is damaged
How should the parents cope when their baby is in NICU?
It may be challenging to think about self-care when the baby is in the NICU. However, it’s very important for parents to take care of themselves as this will enable them to take better care of their baby admitted in the NICU.
Following can be done by the parents to cope with the situation:
- Stick to a daily routine
- Connect with other NICU families
- Take breaks from NICU
- Talk to a counselor
- Be honest about your emotions
- You and your partner need to stay strong together
What is Kangaroo Mother care (KMC)?
Kangaroo Mother Care is a method of care of preterm infants. The method involves infants being carried, usually by the mother, with skin-to-skin contact.
It is a potent, simple strategy for promoting the health and happiness of both full-term and preterm infants.
Its key features are:
- Early, continuous, and prolonged skin-to-skin contact between the mother and the baby.
- Early exclusive breastfeeding (ideally).
What are the benefits of Kangaroo Mother Care (KMC) ?
The benefits of KMC are:
- Keeping the baby warm
- Promoting and sustaining breastfeeding
- Decreasing risk of infection
- Promoting bonding between baby and mother including other family members
- Decreasing the risk of apnea in premature babies
What are the special considerations to be taken care once the baby is discharged form hospital?
Two special considerations for taking care of small sick newborn at home are as follows:
- Infection prevention
- Handwashing before touching the baby
- Feeding bottles and utensils should be kept clean and disinfected
- Preventing unnecessary touching and cuddling of the baby
- Preventing hypothermia
- Keeping the baby wrapped and covered properly
- Kangaroo Mother Care at home
Source: WHO, Center for Disease Control (CDC)