“Sometimes the smallest things leave largest impressions in your heart”. World prematurity day is a chance to show and extend our support and love to the tiny warriors who are born too soon and face numerous health challenges. We celebrate world prematurity day on November 17th every year to increase awareness about prematurity. The theme of 2021 for prematurity is “ Zero separation Act now. Keep parents and babies born too soon together”.
Approximately 15 million babies are born preterm annually worldwide. It is the leading cause of mortality among children aged under 5 years with a majority of deaths occurring in the neonatal period.
What is Prematurity?
Babies born before 37 weeks of completed pregnancy are classified as preterm neonates or said to be born early. Extreme preterms are babies born too early before 28weeks of pregnancy and face way more challenges in survival.
What are the causes of premature birth?
Premature birth can be caused by a problem with the fetus, the mother, or both. Often pinpointing the cause is difficult. Some of the most common causes include:
● Problems with placenta, uterus, or cervix
● Multiple gestations (Twins, triplets, or more)
● Maternal hypertension or chronic conditions
● Infections in the mother
Why is prematurity a concern?
Premature babies are born before their bodies and organ systems have not completely matured. These babies are often small and may need help breathing, feeding, staying warm, and are vulnerable to infections.
What are the challenges faced by premature babies?
Respiratory distress syndrome (RDS) -- a condition where baby finds difficulty in breathing due to immature lungs. Preterm babies often require oxygen support by various types of noninvasive and invasive ventilation and surfactant administration directly into the lungs.
● Patent ductus arteriosus (PDA): A heart condition that causes blood to divert away from the lungs.
● Feeding difficulties: Premature babies are often unable to suck and need to be fed via a tube into the stomach until the sucking and swallowing reflex is developed and later paladar feeds until they are ready for breastfeeding.
● Hypothermia: The temperature control center in a premature baby’s brain is immature and also body fat is low. Babies are therefore cared for under special overhead heaters or in enclosed incubators until they are mature enough to be cared for in a normal cot.
● Apnea of prematurity: Apnea is temporary pauses in breathing due to immaturity of the respiratory centre. They require stimulation at that time and support in breathing if apnea is repetitive and also some medicines like caffeine are given till the baby is mature enough to overcome this condition.
● Neonatal jaundice: The skin takes on a yellow color, due to a compound in the blood called bilirubin. A premature baby’s liver is too immature to process the bilirubin properly. Special phototherapy lights are used to treat jaundice.
● Retinopathy of prematurity is due to abnormal growth of the blood vessels in a baby's retina. Sometimes LASER surgery might be needed to cure this condition. for the same.
Can pre-term babies have long-term problems?
Premature babies are also at a higher risk of developmental challenges like cerebral palsy, learning disabilities, hearing and vision problems. This in turn depends on their degree of prematurity and the severity of illness they experienced following birth.
On this eve of world prematurity day, let us take a moment to shine a light on the risks and hardships faced by a premature baby and extend love and compassion to the families who faced premature births.
(Dr. Sudha B, senior consultant neonatologist, Yashoda Hospitals, Hyderabad)
