Prematurity and Sick Newborn
Pre-term (also known as premature) infants are those which are born before 37 weeks’ gestation (time within the womb). With modern care during pregnancy and with neonatal (the period immediately after birth) intensive care, it is now possible for many babies that are born prematurely to survive. The majority of these babies do so without significant long-term problems. A few babies are now surviving from as little as 23 weeks’ gestation, although at these extremely short periods of gestation, there is more concern about long-term problems and the developmental outcomes for these babies.
Sick full-term babies (that remained in the womb for the correct amount of time) and babies requiring surgery are also treated in neonatal units. Some pre-term or sick newborns may remain in the baby unit for many weeks or even months. The birth of a premature or sick newborn baby can therefore be a traumatic event for a family. The prolonged stay in hospital, which may be necessary, can place tremendous strains on a family, disrupting the normal pattern of family life over an extended period. Many neonatal units will have family support strategies in place to provide help for the families concerned.
Medical text written November 1991 by Contact a Family. Approved November 1991 by Professor M Patton, Professor of Medical Genetics, St George’s Hospital Medical School, London, UK, and Dr JE Wraith, Consultant Paediatrician, Royal Manchester Children’s Hospital, Manchester, UK. Last updated October 2010 by Dr R Rivers, Consultant Neonatologist (Emeritus), Imperial College NHS Healthcare Trust, St Mary’s Hospital, London, UK.
Pre-eclampsia is an established reason for the medical team to decide that it would be safer for mother and baby if the delivery was early. Other factors that may contribute to premature births are early breaking of the waters, smoking by the mother, acute or prolonged stress in the mother, the mother having a poor diet, the mother abusing drugs and certain infections in the mother. Multiple births may deliver early. In some cases the cause of premature birth may not be known.
Providing breathing support and therapy to improve the function of the lungs is important initially, but breathing support may be needed for many weeks in the most immature babies. Jaundice is treated with special lights over the baby and nutritional and fluid needs may be provided by infusions into a vein and with tube feeds into the stomach. Drugs may be required to close a connection between two blood vessels close to the heart if they do not close spontaneously and babies are closely monitored for signs of any infection and for the development of anaemia, which may require blood transfusion to correct it. Keeping the baby warm and experiencing appropriate contact with parents is a vital part of care and the nurses will be encouraging contact from the earliest days.
Some babies, particularly if born very early or with severe infections may not be able to be helped to survive. Parents and other family members nowadays receive much professional support in these very sad situations.
Inapplicable in most cases. Some inherited disorders contribute to the premature birth of a baby.
The likelihood of a premature birth may occasionally be predicted earlier in the pregnancy if a known cause is identified in the mother. Generally, the cause of premature birth is often unclear.
The Society is a Registered Charity in England and Wales No.1002973. It provides information, advice and support to parents and families of premature and sick babies.
Group details last updated January 2016.
The Organisation is a Registered Charity in England and Wales No. 1060508. It provides information for parents-to-be on stillbirth, premature birth and miscarriage, and funds research into pregnancy problems. It took over the work of the Toxoplasmosis Trust and provides information on Toxoplasmosis infection in pregnancy.
Group details last updated September 2014.