Premature Babies: Causes, Risks, and Treatments of Preterm Births
If twenty "years ago the survival of premature babies unfortunately presented numerous unknowns, today fortunately the treatments to which preterm babies must undergo have made enormous progress, given that according to the estimates of the WHO more than three quarters of births can be saved. premature. But be careful not to consider all early deliveries in the same way: for example, a newborn born at 23 weeks of gestation can only survive in 40% of cases, at 25 weeks its survival rate already rises to 80% and so on. For this reason, preterm births (which can be spontaneous or iatrogenic, i.e. induced by the doctor) are usually divided into various subgroups: extremely preterm (before 28th week of pregnancy), very preterm (before 32nd), moderately preterm (between 32nd and 34th) and near term (between 34th and 36th) Obviously every extra week spent in the mother's womb is essential for the baby's health.
Main causes of preterm birth: medical, accidental and socio-economic
The causes of preterm birth are numerous and sometimes linked to each other. However, three broad types of reasons can be grouped: medical, accidental and environmental.
The medical reasons include all problems of the uterine type: uterine malformation, distension of the uterus (especially in the case of multiple pregnancy), insufficiently closed cervix, placental abruption and placenta previa can cause premature birth, as well as urinary infections. , diabetes, hypertension in pregnancy and listeriosis.
As for the accidental causes, they are naturally difficult to define, but it is clear that trauma such as a violent blow to the abdomen, a fall and an emergency surgical operation can cause an early birth.
Finally, there are environmental reasons: numerous studies have highlighted a direct relationship between difficult situations, such as the age of the mother (too young or too mature), and premature births. A series of risks have been identified that increase the cases of premature babies: outdoor work in the open air, stairs, long journeys, unusual exertion, strenuous work, long journeys. Of course, if more factors combine, the danger increases.
What are the risks of premature babies?
Premature babies did not have time to complete the process maturation of their vital functions: if no complications arise they finish developing them in the incubator, where they remain for a period ranging from a few days to even a few months. But what risks do premature babies run? Premature birth is unfortunately a serious health problem, associated with a significant risk of pathology and death in the newborn babies, although, as we have seen, improvements in neonatal care have led in recent years to greater survival of very premature babies. Yet premature babies are still at higher risk for adverse health effects and developmental problems than babies. full-term newborns Risks that increase with decreasing gestational age (the less time you spend in the mother's womb, the more risks there are).
In particular, premature babies are at greater risk of neonatal health complications and permanent disabilities, such as mental retardation, cerebral palsy, lung and gastrointestinal problems, vision and hearing loss. to a greater risk of cardiovascular disease, hypertension and diabetes as adults and a possible increase in the risk of developing cancer. Obviously (we reassure all mothers who will be reading these lines terrified) it is not automatic that a premature baby will face these complications, but the odds only increase: there are many premature babies who live a very normal life and there will be more and more.
How to prevent preterm birth: beware of abnormal symptoms
Prevention against the risks and complications of a preterm birth starts with a healthy pregnancy for all the fateful nine months: therefore no smoking, no alcohol, no drugs (and God forbid ...), eat in a healthy and balanced way , be followed from a health point of view from the first period of gestation and report any abnormal symptoms or any previous premature birth to the gynecologist. According to recent studies, it would also be preferable to wait at least 18 months between one pregnancy and the next.
By following these useful instructions, you are already well under way to prevent preterm birth, but to be even more peaceful it is essential, during pregnancy, to consult a doctor in case of fever (since fever is a symptom of infection and an increase in temperature causes contractions, it is necessary to bring down the fever to avoid an early birth), carry out the essential tests (especially the "intravaginal ultrasound, the only one able to pick up a" possible short cervix, one of the most common factors of childbirth premature spontaneous), always remain very alert even if the nine months are going smoothly, do not underestimate some symptoms (uterine contractions, back pain such as kidney pain or pain in the lower abdomen similar to those of menstruation, abnormal downward pressure in the belly , sudden presence of fluid in the vagina) and avoid too much effort, especially from the 28th week.
The care and growth of premature babies: watch out for weight!
When it comes to care for premature babies, an appropriate distinction must be made between infants born before the sixth month of pregnancy, between the sixth and seventh month and between the seventh and eighth: each of these categories has in fact some characteristics and very specific frailties, and therefore needs specific care.
Babies born before the sixth month, therefore extremely preterm, are very small and fragile: their vital functions cannot function without help, they weigh from 500 to 1500 grams, have no immune system and cannot cope with infections. Immediately after the birth they are taken to the resuscitation service for the first very urgent care and then placed in the incubator, which is a sterile environment. If the birth takes place between the sixth and the seventh month, prematurity, as we have seen previously, is defined as very or moderately preterm. In this case, the weight of the newborn varies between 1500 and 2500 grams. The children are assisted in resuscitation or in the intensive care service, depending on their ability to breathe on their own, and are fed via a probe. Finally, babies born in the eighth month, almost at term, are the most robust preterm babies, already able to breathe without assistance, even if at times they may have difficulty breathing and must be subjected to the necessary care. Some infants born near term are even able to breastfeed.
Once the treatment is over and if no particular complications have arisen, premature babies can finally "follow" mom and dad home. At that point it is important to monitor their growth, both in weight and beyond, to make sure they are progressing regularly. Premature babies tend to grow slower than others, but this shouldn't be a cause for concern: if full-term babies typically take 30/40 grams per day, the weight gain scale of a premature baby it is quite different, but it is sufficient to record the gradual changes in weight, before, during and after weaning, to keep the situation under control and constantly report it to your doctor. Other aspects should not be underestimated: at night, for example, it is better to make them fall asleep in the supine position to avoid stomach problems or gastritis or the risk of SIDS, using the co-sleeping technique. Reassure them by accustoming them almost immediately to the use of the pacifier. And since first-born babies do everything a bit late (for example, they start crawling around the year while full-term babies at nine months), create the right conditions, emotional and psychological, so that they can reach everyone as soon as possible. the steps of growth.
