Premature babies - what to expect

November 11

  • Newborn

Premature babies - what to expect

A baby is considered premature if they are born before 37 weeks of pregnancy. Around 60,000 babies a year are born prematurely in the UK  

By Karen McEwen

A baby is considered premature if they are born before 37 weeks of pregnancy. Around 60,000 babies a year are born prematurely in the UK and it remains the leading cause of infant death. Raising awareness surrounding prematurity is helpful so parents have a better understanding of what to expect if their baby is born earlier than full term.

There are many medical reasons why a baby could be born before this time such as mum becoming unwell, baby not growing well during pregnancy or carrying more than one baby. Women often carry guilty feelings when their baby is born prematurely, especially if their baby needs specialised care, but there is often no explanation as to why your baby came earlier than expected and often nothing you could have done to prevent it happening. There are support groups you can access where you can speak to those with knowledge around the subject, as well as other parents who have also had premature babies and can offer information and support.

Definition of premature.

You may also hear prematurity referred to as preterm, premmie and preemie, especially online and in social media groups. Preterm babies can be loosely put into three categories.

Extremely preterm- Less than 28 weeks gestation.

Very preterm- 28-32 weeks gestation.

Moderate to late preterm- 32-37 weeks gestation.

 

Why a baby can be born prematurely

There can be many reasons why a baby can be premature, but the main ones are here:

  • Rupture of membranes (waters breaking). This can then mean that labour starts. If it is very early then the medical staff will discuss the options, such as the possibility of trying to stop contractions with medication.
  • Having an infection which triggers labour to start. This could develop from the waters having broken (although antibiotics are usually given to try to prevent this). Or from a urine infection, again this can be treated to try to stop labour.
  • Multiple pregnancies. Twin, triplets or more can often trigger labour as the uterus becomes larger and more stretched.
  • In some women their cervix may start to dilate before full term. If this happens in more than one pregnancy a procedure can be offered by the medical team to help it stay closed (a cervical suture- a stitch in the cervix).
  • Babies with certain genetic conditions can be more likely to be born early.
  • Health problems during the pregnancy, such as developing pre-eclampsia.

 

Depending on their condition and how early they were born, premature babies will need different levels of care, this will be assessed at birth by a specialised team of neonatal doctors and nurses. If a baby is expected to need more specialised help, they may need to be moved out of area to a unit which provides this, or that has capacity to accept the baby. This could happen during the early stages of labour or shortly after the baby is born.

 

The medical care available for premature babies

Although a premature baby will look just like a small full-term baby, their bodies and organs are often under-developed, and they usually need specialised care for a while. This can range from observations being done regularly to check on their wellbeing, to intensive life support treatment.  Knowing what to expect if a baby is admitted to a unit because they need extra support can help relieve some of the anxiety surrounding having a premature baby.

Neonatal Intensive Care Unit (NICU) - This provides the high level of care and expertise and is usually for extremely preterm babies. The NICU is not only for premature babies, so expect to see full term babies who need extra medical care after they are born there as well.

Special Care Baby Unit (SCBU)- This is usually for babies from 32 weeks gestation, who are doing well and not needing as much additional input.

Transitional Care (TC). Beyond 34 weeks, babies who are thriving but need some extra observation usually need Transitional Care (TC). TC wards are often next to general postnatal wards but will have a dedicated nurse or midwife, as well as access to a neonatal team if needed.

Due to research and the continual improvement in treatments for preterm babies, a baby born at 24 weeks now has a 60% chance of survival. This rises to greater than 90% at 28 weeks, and a baby born after 34 weeks has the same chances of survival as a full-term baby, if there is quick access to medical care should it be required.

Unfortunately, prematurity is linked with disabilities as your baby may not have had enough time to develop in the womb before being born. One in ten premature babies will be permanently affected by their disability, which can mean having problems which are related to their brain (cerebral palsy), lungs (breathing difficulties) or have loss of hearing and sight.

Summary

Having a premature baby can be quite unexpected and scary for families. Although this can be a frightening time, advances in medicines and the facilities available, mean that even extremely premature babies have a much better chance of survival than a few years ago.

For further support with a premature baby is provided by best beginnings