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The Preemie Primer

The Preemie Primer

Being early is not always desirable, especially when it comes to childbearing. We give you the facts on this elusive yet acute issue.


Madam Helena Foo was 28 weeks pregnant with her second child when her water broke and she was rushed to the National University Hospital. It was also around this time that the expectant mother found out that she was down with fever. She was hospitalised for three days before doctors strongly recommended an immediate delivery to protect the foetus from the increasing risk of neonatal infection.

Baby Shane was born and came in at just under three pounds (approx. 1.3kg). “We were told that babies born under the “very premature” category have a greater than 95 percent chance of making it,” recounted Helena. Still, the baby was in dire condition and was fighting for his survival. “He could barely open his eyes and couldn’t breathe on his own,” she says. Helena did not get to hold her newborn until two weeks later, during which he was monitored in an open incubator and inserted with breathing tubes and an IV through the navel. Thankfully, both mother and child made it through the ordeal, with Shane growing up as a healthy child.


Fastest Foetus First

Stories like Helena’s are one of many cases of premature or preterm labour, which is a more prevalent issue than we think. Notable people like Sir Isaac Newton, Mark Twain, and Sir Winston Churchill were all buns that escaped the oven ahead of time. According to the World Health Organization (WHO), an estimated 15 million babies are born preterm every year, with this figure steadily increasing.

A birth is termed premature when it occurs more than three weeks before the baby is due, which is around the 37th week of a woman’s pregnancy.Preterm birth is classified into extremely preterm (less than 28 weeks), very preterm (28 to under 32 weeks), and moderate preterm (32 to under 37 weeks), with most premature births occurring in the moderate phase.

The final few weeks in utero are the most crucial for the growing foetus, since this is the time when there is significant development in the baby’s brain, lungs and liver. When a baby is born too soon before the full 40 weeks – also known as a preemie – it has less time to develop in the womb, thus becomingmore susceptible to brain bleeds, heart defects and breathing problems, among other health problems.


Warning: Eager Embryos

Astudy last year showed that about 12 percent of women have a chance of preterm labour during pregnancy, and that most of them can be avoided by understanding the specific red flags if and when they show up.

Keep track of the flow and type of your vaginal discharge right up to 37 weeks into your pregnancy. These secretions are perfectly normal during pregnancy, but if you notice an increase in discharge or if it becomes watery, pink, or viscous, this may be a harbinger of preterm labour.

Another symptom may be extra pressure in your pelvic area or vagina. This may be caused by your baby pushing downwards towards the exit, resulting in the feeling of your baby “falling out”. Backpains predominantly in the lower back, menstrual-like cramping, and sporadic early contractions every 10 minutes are other warning signs you should pay heed to.

These signs may appear to be no different from the usual symptoms experienced during normal pregnancy, so it is always better to err on the side of caution and sound out your doctor immediately. A dose of women’s intuition can also come in handy at this point.


Preemie Perils

Preterm birth can pose a risk to preemies, especially if it happens in the earlier stages. The later the birth, the less vulnerable they are to both short- and long-term complications. As in the case of Shane, preemies may encounter breathing difficulties in the first weeks due to an immature respiratory system or a lack of surfactant in the lungs, which enables the lungs to expand.

Heart problems are common short-term issues, the most frequent being low blood pressure and patent ductus arteriosus (PDA), which is a persistent opening between two major blood vessels from the heart. This defect usually closes on its own, but can cause heart failure when left untreated. Preemies are also highly susceptible to infections like sepsis, pneumonia, and urinary tract infection due to their underdeveloped immune system.

In the long run, prematurely born infants may face more serious health problems. A study of 241 children born between 22 and 25 weeks by researcher Dr. Neil Marlow, a neonatologist at the University of Nottingham, found that 46 percent had severe or moderate disabilities such as cerebral palsy, vision or hearing loss, and learning problems.“Parents need to go into this situation with their eyes wide open and with an open dialogue with their doctors as to what they should do,” Marlow advises.


Closing The Barn Door Before The Horse Is Out

Despite the great strides made in modern medicine and treatment, most of these efforts have been geared towards treating preemies, with a dearth of progress and research on prevention.”We don’t understand the mechanism of preterm birth enough to come up with safe, effective ways to prevent it,” says Ronald Gibbs, M.D., chair of the Department of Obstetrics and Gynaecology at the University of Colorado Health Sciences Center. “Strategies so far have focused on trying to stop preterm labour, but that’s like closing the barn door after the horse is out.”

What parents can do is to stay on top of things by equipping themselves with knowledge on the factors that may increase the probability of premature birth.

Poor nutrition and not gaining enough weight during pregnancy can contribute to conceiving a preemie. The best way to minimise the chances of an unscheduled delivery is to seek early prenatal care the moment you are pregnant. Your doctor can begin monitoring your progress and giving you the best medical and nutritional advice, while screening you for possible infections that are detriment to a healthy pregnancy.


Your birthing history may also count against you. Some pregnant mums are more likely to go into labour earlier than others, especially if they have experienced a previous premature birth before. Those who have gone through high-risk pregnancies involving twins are more at risk, along with parents who have undergone procedures like abortion and multiple miscarriages.

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