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Complications of Preterm Birth
Many of us know a baby who was born too early and who is doing just fine. Most premature babies catch up to their full-term peers within a year or two of their birth. But some premature babies are not so lucky. Their low birthweight and insufficient physical development result in lifelong health problems. Some of these children struggle every day to survive. The smallest or sickest die at birth or shortly afterwards. Babies born before 32 weeks of pregnancy are at greatest risk. To learn about the risks babies face when they are born before 28 weeks, from 28-31 weeks, from 32-35 weeks, or at 36 weeks, see the March of Dimes fact sheet on preterm birth. Here’s what you need to know about the most common medical complications a premature baby can face:
Respiratory Distress Syndrome (RDS): Babies with RDS lack a protein called surfactant that keeps the small air sacs in their lungs from collapsing. Luckily, many babies with RDS can be treated with synthetic surfactant. These babies usually need help breathing as well. About 40,000 babies in the United States are affected with RDS each year. Most of these babies are born before the 34th week of pregnancy.
Intraventricular Hemorrhage (IVH): Intraventricular hemorrhage is the medical term for bleeding in the brain. Most bleeds occur in the first four days of life and get better by themselves with little or no permanent damage. Some severe bleeds require medical intervention and can cause brain damage that results in mental retardation, developmental disabilities or cerebral palsy. IVH occurs in 10–25 percent of babies born before the 34th week of pregnancy.
Necrotizing Enterocolitis (NEC): NEC is an inflammation that damages the lining of the intestine. It can lead to feeding problems, abdominal swelling and other complications. NEC is treated with drugs and sometimes surgery. About five percent of premature babies develop NEC, and the earlier the baby is born, the higher the risk. Some babies with NEC die, despite treatment.
Retinopathy of Prematurity (ROP): ROP is an eye condition caused by the abnormal growth of blood vessels. It can result in vision loss and blindness. In some cases, ROP gets better by itself; in other cases, it is treated with a laser or cryotherapy (freezing). It occurs mainly in babies born before the 32nd week of pregnancy.
Bronchopulmonary Dysplasia (BPD): BPD is a chronic lung disorder occurring in premature babies born before their lungs are sufficiently developed. Babies born with severe lung disease usually require days or weeks of breathing support from a respirator (breathing machine); these babies may develop BPD, which causes the lungs to scar. Some babies outgrow the scarring within the first two years of life. In other children, BPD causes a chronic asthma-like condition with breathing difficulties. This condition can last for many years.
Infections: Premature babies are at higher risk of developing infections than full-term babies. Their immune systems are immature and not as able to fight off infections. Common infections seen in premature babies include sepsis (a blood infection), pneumonia, and meningitis (infection of the membranes surrounding the brain). Infections are treated with antibiotics or antiviral drugs.
Anemia: Premature babies are often anemic, which means that they do not have enough red blood cells. Babies with anemia may have feeding problems and grow slowly, and anemia also can make heart or breathing problems worse. Anemia is treated with iron supplements, drugs that increase red blood cell production, and, in some cases, a blood transfusion.
Patent Ductus Arteriosus (PDA): PDA is a heart problem that is commonly seen in premature babies. A large blood vessel (the ductus arteriosus) is supposed to close at birth and allow the baby’s blood to circulate normally. In PDA, this blood vessel does not close. In some cases, drug treatment can help close the passageway. If that does not work, surgery is needed.
Apnea: Apnea occurs when a baby stops breathing for 15 to 20 seconds or more. It is often accompanied by a slow heart rate, which is called bradycardia. Premature babies are constantly monitored for apnea and bradycardia. Doctors and nurses who care for premature babies call these conditions the “A’s and B’s.” If a baby stops breathing, the monitor will sound. Usually the baby can be stimulated to start breathing again with a pat on the back or feet.
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Information specialists at the March of Dimes help answer your questions by e-mail and online chat. |
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