|Prematurity is defined as infants delivered before 36 weeks gestation. Low birthweight is defined as less than
2500 grams. Very low birth weight is defined as less than 1500 grams.
|Prematurity can be caused by many factors:
~inadequate prenatal care;
~twins, triplets, quadruplets, etc.;
~infections in the third trimester;
~premature rupture of membranes;
~congenital abnormalities of the fetus
|Physical and Developmental
Characteristics of Premature
presence of body hair (lanugo);
absence of skin creases;
reddish skin color;
absence of ear cartilage;
floppy muscle tone;
extended, rag-doll position;
reduced flexibility of the joints;
primitive reflexes not
|Early Problems For Premature Infants
Inability to breathe or breathe regularly on their own due to underdeveloped lungs;
Body temperature regulation (the baby cannot maintain his or her own body heat);
Feeding and growth problems because of an immature digestive system;
Jaundice (yellowing of skin and possible brain damage due to buildup of bilirubin, a blood breakdown product);
Anemia (not enough red blood cells to carry oxygen to tissues);
Intracranial hemorrhage (bleeding into the brain).
Problems Premature Infants Face as They Grow Older
Apnea, episodes of stopping breathing, which may require special monitoring, even at home;
Bronchopulmonary dysplasia, a chronic lung disease that may or may not improve as the child grows;
Hearing or vision problems related to immature nerve or treatment side effects;
Developmental delay and learning disabilities from brain damage related to immaturity.
Because premature babies can be very ill, especially extremely premature infants, decisions about treatments can be
difficult for parents, doctors and nurses. Medical research studies provide information about treatments and the likely
course of an illness, but they cannot predict how each baby will recover from being born too early.
|Possible complications resulting from premature birth:
Respiratory Distress Syndrome
Respiratory failure resulting from inadequate surfactant production in premature infants;
leads to lack of expansion of alveoli and poor gas exchange. Ventilation is often needed.
A chronic lung disorder that occurs in about 7% of premature infants with respiratory distress
syndrome. It is associated with "stiff" lungs that do not permit adequate gas exchange and
frequently leads to dependence on ventilator assistance for extended periods of time.
|Patent Ductus Arteriosis
After birth, the ductus arteriosis, which connects the aorta and the pulmonary arteries, closes. In about 30% of premature infants,
this does not close. This can lead to heart failure. Treatment can include medicine or surgery to close the duct.
Apnea and Bradycardia
Apnea is an episodic arrest of breathing. In a premature infant, this can lead to bradycardia, in which the heart rate slows, usually to
fewer than 60 beats a minute. Lack of respiratory effort can be treated with a caffeine-like drug, or a bed that rocks. Chronic apnea
is a warning sign; more than 20% of Sudden Infant Deaths are in premature babies.
Premature infants have a fragile network of blood vessels that supply the brain. These are particularly sensitive to changes in
oxygen and pressure. Decreased cerebral blood flow and increased intracranial pressure may lead to brain damage, a cause of
spastic diplegia (cerebral palsy) or mental retardation.
The gastrointestinal system in a premature infant is also very delicate. Necrotizing enterocolitis develops during the first 2 weeks
of life in 2% -- 5% of very low birth weight infants. This condition has a 20% mortality rate. Abdominal distension, lethargy, and
vomiting are early signs. Sometimes, it may be necessary to remove the diseased section of the intestine.
Retinopathy of Prematurity
This is detachment of the retina and subsequent blindness caused by high levels of oxygen given to premature infants with
undeveloped lungs. But there are other causes, as of yet unknown.
Low body temperature; especially a risk in the premature infant.
Yellowing of the skin and whites of the eyes caused by an accumulation of bilirubin. This often is found in liver disease and Rh
incompatibility; also called icterus.
Low blood sugar; often found in premature infants and infants of mothers with diabetes.