What Is Infant Prematurity?
New-born infants with gestational age less than thirty-seven weeks but more than twenty-eight weeks and weight below 2500 grams are referred to as premature by the WHO (World Health Organization). Since the infant’s development time in its mother’s womb is shorter than what is considered normal, the development and function of its many organs does not reach sufficient maturity either. The nervous system of the child, especially, is underdeveloped. With the inability to adapt to the outside environment and potential hypoxia at birth (low oxygen in the tissues), the infant is most likely subject to immature tissue and organ development as well as a series of health problems and complications. These may include low chances at survival, low resistance, and bodily dysfunction. Typically, the earlier the infant is born, the more prone they are to health complications.
According to how early the infant is born, the child may be a:
- Late preterm – one that is born within 34 to 36 weeks of gestation.
- Moderately preterm – the infant being born within 32 and 34 weeks of gestation.
- Very preterm – born less than 32 weeks into pregnancy.
- Extremely preterm – being born before 25 total weeks of gestation.
How Does Premature Birth Happen?
While the exact diagnosis of premature birth is not entirely known in quite a lot of cases, some reasons alluding to the phenomenon of premature birth consist of:
- The mother having multiple pregnancies i.e., twins or more.
- The mother having complications in her cervix, placenta, or uterus.
- The mother developing an infection, most particularly in the lower genital region or inside the amniotic sac.
- The mother suffering from health complications such as diabetes, hypertension, or anaemia.
- The mother developing a medical condition that is requiring for the infant to be delivered earlier than planned, like pre-eclampsia.
- The mother having a detailed history of previous premature births.
- The mother conceiving via Vitro fertilization.
- The mother having suffered traumatic life events like domestic violence or grief over the loss of someone close.
- The mother having smoked cigarettes or used harmful drugs.
- The mother being overweight or underweight before the gestation period.
What are the Short-term Complications of Premature Birth?
In the first few weeks of an infant being born prematurely, the baby may or may not suffer from health complications. A few of them are listed below:
Heart Complications
The most common health complications experienced by premature infants include hypotension (lower than normal blood pressure) and “patent ductus arteriosus” or PDA. PDA is a constantly appearing opening between the heart’s pulmonary artery and the aorta. Although this heart problem often goes away on its own, it must be constantly checked as leaving it untreated can lead to heart murmur (the swishing of turbulent blood in or near the heart).
Breathing Issues
A premature infant might have a difficult time breathing because of an underdeveloped respiratory system. In this condition, the infant lacks surfactant (that aids in the expansion of the lungs), and the infant may suffer from respiratory stress since the underdeveloped lungs are unable to contract and expand normally.
Premature infants may also contract a lung condition called “bronchopulmonary dysplasia”. Moreover, some premature babies may suffer from breathing with longer-than-average breaks (apnoea).
Temperature Control Issues
Premature infants tend to lose their body heat quickly. This is because they do not have the sufficient amount of fat that normal infants have and cannot generate sufficient heat to make up for the heat lost. If the temperature goes too low, hypothermia can occur.
Gastro-Intestinal Issues
Prematurely born babies are more prone to having premature gastro-intestinal systems. These result in other complications like “necrotizing enterocolitis”, or NEC, which is a possibly serious condition that involves the injury of the cells covering the bowels. This can most likely occur when premature babies start to feed. Infants that are breastfed have a much lower chance of contracting NEC.
Blood-Related Issues
Premature infants are very vulnerable to developing blood problems like anaemia or new-born jaundice.
Anaemia is a commonly occurring condition that involves the body not producing the sufficient amount of red blood cells. Although it is normal for new-borns to experience a drop in their erythrocyte count during the initial months of their life, premature infants may experience a greater decrease.
Infantile jaundice refers to a xanthous discoloration in an infant’s skin and the eyes as well. It occurs when there is excess “bilirubin” in the infant’s blood. Although there are different causes of jaundice, it is a more common occurrence in babies with premature births.
What are the Chronic Complications of Premature Birth?
Premature birth may also allude to the following long-term complications:
Cerebral Palsy
It is a muscle or posture disorder that is caused by either infection, insufficient blood flow, or damage to the infant’s brain while it is going through development. This can be during the mother’s early gestation period or when the infant is still premature.
Psychological Problems
Children who have suffered from premature birth are more prone to develop psychological or behavioral disorders as well as developmental impediments.
Chronic Health Issues
Premature infants are more prone to developing chronic health issues compared to full-term infants. They also have an increased risk of SID or Sudden Infant Death syndrome.
Vision and Hearing Issues
Prematurely born babies most likely contract retinopathy of prematurity (ROP) which is a condition that involves the swelling up of blood vessels in the nerves present behind the eye. Sometimes the aberrant retinal vessels damage the retina and displace it. This can further lead to a retinal detachment which can cause visual impairment or blindness in the child.
Difficulties Learning
Prematurely born babies are more prone to be late bloomers compared to full-term babies. At the prematurely born child’s schooling age, the child might develop learning disabilities.
What are the Symptoms of Premature Birth?
An infant may either have mild symptoms after premature birth or more evident complications. Following are the signs of prematurity at birth.
- Small body with a large head that may seem disproportionate.
- Less rounded and sharper looking features compared to a full-term infant’s features. This happens due to the lack of fat storage.
- Lanugo or fine hair covering a majority portion of the body.
- Lower than normal body temperature, especially right after birth, again due to lack of stored fat in the body.
- Respiratory distress and/or labored breathing.
- Weakened reflexes for suckling and swallowing which lead to difficulties feeding.
What are the Weight Standards for Premature Infants?
In prematurely born babies, the usually recorded birth weight tends to be below 2500 grams, and their head circumference happens to be below 33cm. Some premature infants who weigh more than 2500 grams but have worse organ function and adaptability compared to full-term infants should still be put under intensive care. Any infant with their birth weight decreased to below the tenth percentile of the normal recorded weight of the gestational age, or one that is two standard deviations below the recorded average (often due to the placenta functioning insufficiently, besides other factors), is known as a “small for gestational” baby. Those having a birth weight of below 2500 grams are referred to as low birth-weight infants, and those with a birth weight below 1500 grams are called very-low birth-weight infants.
How Much Weight Is Referred to as “Normal” for Premature Infants?
According to general standards, premature infants weighing more than 2000 grams at birth usually grow to 2700 grams; Preterm infants weighing under 2000 grams at birth grow to about 2500 grams. In these cases, there are no special abnormalities present, and the infant can be sent home safely.
If a premature baby weighs only 1500 to 2000 grams at birth, it takes about one and a half months for the infant to grow to 2500 grams. However, despite the baby growing to more than 2500 grams, it is still much weaker than normal infants and should be taken care of.
What Is the Weight Standard for New Borns?
A new-born infant’s weight is an important indicator that reflects their nutritional status and maturity. For ideal conditions, the weight gain in the neonatal must be greater than 600 grams.
The average birth weight for infants is usually around 3.5 kg, even though infants weighing 2.5 kg to 2.5 kg are also considered healthy. Generally, male infants are usually a bit heavier compared to female infants, and first infants are normally lighter than the siblings that are born after them.
It is also normal for new-borns to lose around 228.6 grams in the first week or so after birth and regain it after 10 to 12 days. In the infant’s first month, it gains 20 grams a day or about 226.8 grams in a week.
Conclusion
Premature birth is a serious problem experienced by many throughout the world. Developing a much better understanding of the causes of premature birth as well as learning to attempt to prevent such incidences are needed to improve access to efficacious neonatal care.
