Complications of Preemies

The American Pregnancy Association defines premature babies as those born before the 37th week of pregnancy. The U.S. Center for Disease Control (CDC) estimates that one in every eight babies is born prematurely each year, a figure that rose over 16 percent from 1996 to 2006. While complications from prematurity are the number one killer of infants in the United States, medical science has made a number of advancements in how preterm infants are treated which has led to improved survival rates.

Significance

• According to the CDC, complications from prematurity can include immature lungs and apnea---when a baby stops breathing for a period of time. Jaundice, anemia and intraventricular hemorrhage (IVH), a dangerous type of brain bleed, are other difficulties often encountered by premature infants. They also tend to lack the ability to regulate their body temperatures and they have immature digestive systems. Premature infants can also develop anemia and retinopathy of prematurity, which is a serious eye disorder that can lead to blindness. They are also more vulnerable to infections and can potentially develop complications such as necrotizing enterocolitis (NEC), when part of an infant's intestine suffers poor blood flow, and sepsis, bacteria in the blood stream.

Effects

• Even if babies survive the complications they can suffer due to prematurity, the American Pregnancy Association projects that they might develop some serious lifelong disabilities including cerebral palsy, learning difficulties, behavioral disorders, breathing and respiratory problems, feeding problems and vision and hearing loss. Extreme prematurity is also an expensive societal problem, with the CDC estimating the annual societal cost of prematurity in 2005 at $26.2 billion, a number which includes the medical, education and lost productivity costs associated with early births.

Misconceptions

• For years, many doctors operated on the mistaken assumption that "late" preterm infants, which the March of Dimes defines as those born between 34 and 36 weeks, were unlikely to face any substantial medical or developmental problems as a consequence of their prematurity. Healthy late preterm babies were often briefly screened at the hospital and then routinely discharged and sent home with their parents. According to the March of Dimes, several research studies in 2008 and 2009 have found that these babies are three times as likely to develop cerebral palsy as their full-term counterparts. They also have determined that they are more likely to have developmental difficulties and learning disabilities during their school years.

Prevention/Solution

• The March of Dimes asserts that by paying careful attention to the risk factors for premature birth and ensuring that scheduled C-sections and inductions are not planned prior to 39 weeks gestation, doctors can help prevent prematurity and its complications. Women can help reduce their likelihood of having a premature birth by ensuring they see their doctor regularly for prenatal check-ups and by not smoking, drinking alcohol or taking illicit drugs during pregnancy.

Potential

• While the risks of complications due to prematurity remain high, a 2009 study in the Journal of the American Medical Association found that 70 percent of babies born between 22 and 26 weeks gestation are now surviving past the age of 1. Babies at the youngest gestational ages had the lowest survival rates and faced long-term difficulties. As science pushes the limits of viability, medical researchers struggle to determine at what point the benefits of survival outweigh the physical costs to these babies.