When moms learn they are pregnant, one of the first things that they do is circle the due date on the calendar. But up to 9 percent of moms won't make it to 40 weeks or even 37 weeks. They will deliver their little one before 37 weeks, which is considered premature and comes with a host of health complications and concerns.
There are a number of reasons that babies are born early and a lot of them have to do with the health of the mom or the little one. But sometimes it just happens — moms go into labor early spontaneously and they don't know why. Sometimes it's predictable, and sometimes it's not, although a new test might help doctors determine when it might happen.
Preemies aren't just tiny; they are very fragile. Because of modern healthcare, babies are surviving premature birth even if it comes not long past the halfway mark in the pregnancy. But those babies are very vulnerable in their first few weeks of life, and they may not come home from the hospital for months. The impact of their premature birth might stay with them into adulthood as well. Many of these babies are absolute miracles, and their moms need to be armed with information to help them grow and thrive.
Here are 10 things doctors have to say about premature babies and 10 ways to predict it.
Going into labor early can be really scary. And unfortunately, many moms know that their child's chances aren't great if they come too early. The health concerns are there for any baby born before 37 weeks gestation, but those who come between 24 weeks and 28 weeks are called micropreemies, and there is a pretty big chance that they won't make it.
There are some doctors who won't consider life-saving interventions if the baby comes before 24 weeks, but at that point, the baby does have a chance of survival. In fact, more than half of babies born that early will make it. That chance goes up to 90 percent by 26 weeks. Although there could still be some short- and long-term problems, thanks to modern medicine, more and more little ones can make it.
A baby born prematurely is likely to spend some time in the Neonatal Intensive Care Unit. And if the baby is very premature, those first few weeks could be pretty rocky. The baby might seem stable for a time only to need surgery or develop an infection. Those ups and downs can be pretty scary, and the baby's health is fragile for a while.
Many babies need to be weaned off of oxygen, and they might have to go back a step for a while. They might take a while to gain weight and even longer to be able to drink a bottle. And some preemies have to go through surgeries in those first weeks. Each journey is different, but unfortunately it can take a while to be out of the woods.
Most micropreemies and a good majority of very premature babies have respiratory distress, which means that they will need assistance with their breathing. There are varying degrees of severity, but the truth is that many preemies are at risk of long-term struggles with breathing.
Some preemies end up with bronchial issues, and they might be more susceptible to respiratory infections throughout childhood. Some end up with asthma, which can impact them the rest of their lives. Lungs are one of the last organs to develop during gestation, so coming early means that those lungs might be underdeveloped and always trying to catch up.
Babies who are born premature are automatically a little behind compared to their peers. But that doesn't mean that they will stay that way. Instead, doctors will tell parents that they need to think about milestones in terms of adjusted age, which is how old the baby would be based on their due date, not the time they were actually born.
It's not fair to expect a baby who came three months early to be grasping things and rolling over like other three-month-olds. But usually by the time the baby is in preschool, he's close to on track. He might not be walking by his first birthday, but he'll be there soon, so moms don't need to worry until they adjust for his prematurity.
It might be the last thing on a mom's mind when she is watching her 3 pound baby struggle to breathe, but the issues of prematurity can last throughout the school years. The issues aren't all physical; they can be neurological as well.
Babies can have cognitive issues and brain damage if they experienced a lack of oxygen, but they can also end up with behavioral issues such as attention deficit disorder. They might have problems with learning, but there are resources in public schools to help.
One of the first questions that moms have — once their preemie is stable — is when the baby can come home. Moms are usually discharged within a day or two of the birth, and they want their little one to come home with them, but with preemies it can be a while.
From personal experience, we know that nurses are quick to let moms know that they can expect their baby to stay in the hospital until the due date, although sometimes it doesn't take that long. Some babies end up with complications that mean that they will have to stay even longer. It's hard to estimate, since the baby has to be able to eat, breathe and grow, but it's usually around the due date when the baby is healthy enough to go home.
A newborn's digestive system can be underdeveloped when they are born on time, so many premature little ones have issues with their digestion when they are born early. Many start to have a condition called necrotizing enterocolitis, which affects the way that food is broken down through the intestines. Sometimes the babies will get better on their own, but other times they might need surgery to remove part of their intestines. That stays with them forever.
Many premature babies can have trouble with the suck, swallow, breathe reflex as well, especially since they are also have respiratory issues. That might mean that it can take a while to figure out how to take a bottle or nurse. These issues usually take time, but they can get better for most preemies.
A lot of organs are impacted by a baby's early arrival. That includes the eyes. A number of babies end up having retinopathy of prematurity, which means that their retinas aren't fully developed. That can lead to vision problems and possibly even blindness.
Sometimes the vision problems aren't apparent at birth, but parents need to schedule regular eye checkups so that doctors can begin treatment right away. If doctors begin treatment right away, they may be able to avoid going blind. They might need glasses for the rest of their life, but there are a lot of people who end up with those anyway.
As researchers continue to investigate the causes and impacts of prematurity, moms and dads know more and more about what to look for to help their little one. In 2015, researchers found that babies who had really low birth weights (which happens when they are very premature) are more likely to have certain disorders as adults.
The psychiatric problems can include depression, anxiety and attention deficit disorder, and they can also have social and communication issues as adults. Many people deal with these struggles as adults anyway, but moms know that they might need to encourage their preemies to get help if they need it later in life.
A mom who is at risk for premature birth hears one mantra from her doctor — the more time in the womb, the better. We've already mentioned that babies born before 24 weeks gestation might not have as much of a chance at life, but there are some 23-weekers that now survive. Doctors definitely look at 24 weeks as a first goal for a mom who might give birth early.
But even after achieving that goal, the doctor knows that every week — even every day — means that the baby has developed more and the risks are decreased. It's not just about survival but about having a better health and quality of life. The longer gestation means healthier lungs and digestive systems. So moms should try to obey doctor's orders and try to delay delivery if they can, although that is not always possible.
A normal pregnancy is 40 weeks, but when there is more than one baby on board, it's not likely to last that long. In fact, the goal changes for moms of twins to 36 weeks, and moms of triplets and more can do all that they can and still deliver two months or more early. Doctors will start warning moms of multiples in the beginning or pregnancy that their babies are likely to come early, so they need to be prepared for the roller coaster ride of the NICU.
The weight of the babies in the uterus can be intense and that means that the mom's body will feel like it's been 40 weeks even if it's been just over half that time. But an early birth doesn't always mean that all of the babies will have long-term impacts, which proves that some preemies can be OK even when they come long before expected.
There are a lot of things that moms can't control that can put them at risk for having a preemie. Just one of those factors is age. Premature birth is more likely to happen with really young moms and with older moms. Those moms who are younger than 18 and older than 30 are at increased likelihood of a number of issues, and that means that they could end up having the baby early because of those complications.
While teen motherhood is on the decline, these days more women are waiting until they are older to have children. Fertility medications are making it more possible to have a baby in your 30s or even 40s, but many times those little ones are born early. So be sure to know the signs of early labor so that you can do all that you can to give the baby more time.
Sometimes the baby has to be delivered early because the mother's health is at risk. The most common issue for that is when the mom's blood pressure spikes. In those cases the baby is also having trouble, so the doctor weighs the risks of prematurity with the risk to the health of the baby and the mom.
If a mom has high blood during pregnancy, the doctor is likely to put her on medications and bed rest in hopes of delaying the delivery as much as possible. But when the situation gets problematic, the baby has to be delivered immediately. A spike in blood pressure can indicate preeclampsia, which can be an issue to both mom and baby, so that is a big emergency and the only cure is delivery, whether it is too early or not.
In pregnancy, there are things that can run in the family. For premature birth, if it happens once, it's possible that any future children could also be preemies. That's because a lot of the same conditions can exist in another pregnancy such as health complications for mom.
Going through the NICU experience one time can be harrowing but knowing you can go through it again can be scary. And if the baby comes earlier, there are even more risks involved. But at the same time, knowledge of the situation means it might be possible to delay the delivery and understand what will happen for the baby and the family.
It's not just about the mom when it comes to the baby coming early. There are some health conditions in the baby that might lead to the decision to have an early delivery. Some of those conditions can be determined in an ultrasound, so moms have some time to prepare and investigate the situation.
One of the most common health concerns that can lead to premature birth is if the baby has restricted growth. While the womb might be the safest place for some babies to be, if the baby isn't growing that might mean that the baby is not thriving , so it's safer for them to be delivered so a doctor can start treatments.
Another big issue that can lead to a premature birth is if the mom has diabetes, either type 1, type 2 or gestational diabetes. The condition means that the mom has a hard time processing sugars, and it can lead to an increase in infections and other issues for the mom, and that situation can be passed along to the baby.
Moms have to work hard during pregnancy to try to manage their condition through diet and maybe medication. But the most precarious time for the baby can come at the end of the pregnancy. Moms with diabetes are at an increased risk of stillbirth, so doctors weigh the risks to predict the best time to deliver. Sometimes that means a premature birth is in the cards.
To sustain a pregnancy to term, a mom's body needs to cooperate. But if her cervix or her uterus aren't up to the job, that might mean that the baby is going to come early. There are some women whose reproductive organs are weak or they were born with odd shapes. A shortened cervix, for example, can be a big problem.
Doctors might be able to predict concerns about the cervix or uterus through an ultrasound. They might recommend bed rest to try to delay the delivery as much as they can, but sometimes the body just can't handle going any further. But luckily there is quality care in the NICU to help the baby in those first fragile weeks.
Even if the mom follows all of the rules and the doctor's orders, it's hard to avoid a premature delivery for some. But there are some risks of having a preemie that moms can avoid. They can avoid smoking, alcohol and other similar habits.
Those bad habits are unhealthy for mom, but they are even more unhealthy for the baby. The little one is likely to have an even lower birth weight and there is an increased risk for a birth defect. It's also likely for complications to arise. All of that combines to an increased likelihood for premature birth. But if you cut out on those habits for pregnancy, the baby is likely to be in longer and be healthier.
This last risk is a little harder to predict ahead of time, but once a doctor diagnoses a mom with an infection, it's likely that the baby will have to be delivered early. We're not talking about the common cold or a sinus infection, which can be bothersome but not necessarily serious, but a more serious infection can threaten the life of the baby and the mom.
Treating an infection can be difficult when you are pregnant, since medications can go through the placenta to the baby. Many times the safest option for the baby is to be delivered and sometimes the body starts the work before a choice can be made. But the doctors in the NICU can be on hand to help the baby, while the doctors also treat the mom's infection.
Medical breakthroughs not only help in the treatment of premature babies, but a new scientific study means that doctors may soon be able to predict a premature birth. Researchers at Stanford have developed a blood test that can predict prematurity with up to an 80 percent accuracy.
This test, which is still in the trial phase, predicts whether the mom will go into labor early, although we've already noted that there are times when doctors decide it would be safer to deliver early without the mom going into labor. The blood test might help doctors to figure out preventive measures that would give the baby a little more time, which can make all the difference in terms of health.