Premature Births and its Affects

Monica Paar, Claire Woodward, Clara Sweeney, Megan Malina, & Megan Nielsen

Health Problems Before Pregnancy

•Asthma•Depression•Diabetes•Eating Disorders•Epilepsy and other seizure disorders•High Blood Pressure• STI•Thyroid Disease

Health Problems During Pregnancy• Anemia: Lower than normal number of healthy red blood cells.• Depression: Extreme sadness during pregnancy or after birth (postpartum)• Ectopic: When a fertilized egg implants outside of the uterus, usually in the

fallopian tube• Gestational Diabetes: too high blood sugar levels during pregnancy• Hyperemesis Gravidarum: Severe, persistent nausea and vomiting during

pregnancy- more extreme than “morning sickness”

Women are at greatest risk for premature labor if:

• They are pregnant with multiples• They have had a previous premature birth• They have certain uterine or cervical abnormalities

Medical risk factors include:

• Recurring bladder and/or kidney infections

• UTIs, vaginal infections, and STIs

• Infection with fever greater than 101 degrees F during pregnancy

• Unexplained vaginal bleeding after 20 weeks of pregnancy

• Chronic illness such as high blood pressure, kidney disease or diabetes

• Multiple first trimester abortions or one or more second trimester abortions

• Underweight or overweight before pregnancy

• Clotting disorder (thrombophilia)

• Being pregnant with a single fetus after in vitro fertilization (IVF)

• Short time between pregnancies (less than 6-9 months between birth and beginning of the next pregnancy)

Lifestyle risks for premature labor include:

• Little or no prenatal care• Smoking• Drinking alcohol• Using illegal drugs• Domestic violence, including physical, sexual or emotional abuse• Lack of social support• High levels of stress

Other options from MayoClinic.org

• Seek regular medical care• Eat a healthy diet• Avoid risky substances• Consider pregnancy spacing• Be cautious when using/choosing assisted reproductive technology

(ART)

Doctor recommendations:

• Preventative medications• Limiting certain physical activities• Attempt to manage chronic conditions

Signs and Symptoms of Premature Labor: Basic Facts• A preterm birth is one that takes place more than three weeks before

the due date• The baby then has less time to fully develop when it is born preterm.• There are different categories of preterm births• Late Preterm is 34-36 weeks• Moderate Preterm is 32-34 weeks• Very Preterm is 32 weeks• Extreme Preterm is before 25 weeks

*Most occur in late preterm

Signs of a Preterm Baby

• Small size, disproportionally large head• Fine hair• Low body temp• Labored breathing• Lack of reflexes for sucking and swallowing• Sharper looking, less rounded features• Due to lack of fat stores

More Facts

• Preterm birth is leading cause of long-term neurological disabilities in children.• Preterm labor begins unexpectedly and the cause is unknown.• There are about 500,000 preterm births a year• That’s about 1 out of every 8 births.• Premature babies need special medical care until organ systems can

work on their own.

What is Preterm Labor

• Labor is preterm if it is 3 or more weeks before due date• ¼ of preterm births are planned• If mother or baby has complications, may induce labor or preform a

caesarian.• Other ¾ are spontaneous preterm births

Complications of Premature Birth: Short Term• Breathing complications

• Underdeveloped lungs

• Immune system problems• Infection

• Temperature regulation problems • Blood problems:

• Jaundice• Anemia

• Metabolism problems• Inability to regulate glucose

• Gastrointestinal problems• NEC

• Brain problems • Risk for bleeding in the brain

• Heart problems• PDA• Low BP

Complications of Premature Birth: Long Term• Cerebral Palsy• Impaired cognitive abilities • Vision & hearing problems• Dental problems• Behavioral/psychosocial problems• Chronic health issues

Age of Viability

• Viability: Term in pregnancy when, if the baby is born, he/she will have a reasonable chance of survival• 24 week gestation is the usual cutoff for physicians • Any younger, and most physicians/neonatologists will not intervene or

resuscitate a baby

Complications at 28 or Fewer Weeks

• Fewer than 1% of babies are born at 28 or fewer weeks• Low birth weight• Less than 2lbs 3oz

• 25% have lasting complications• Disabilities • Learning/Behavioral problems

• Most complications of all babies • Inability to breath on own: oxygen & surfactant treatments required • Cannot suck/swallow on own: fed intravenously

Complications at 28-31 Weeks

• 96% of babies born at 28-31 weeks survive• Low birth weight• 2-4lbs

• Complications: • Inability to breath on own: oxygen & surfactant treatments required • Some have an inability to suck/swallow: fed through tube in nose or

intravenously

Complications at 32-33 Weeks

• 98% of babies born at 31-33 weeks survive• Low birth weight• 3.5-4lbs

• Complications• Some can breast/bottle feed (if baby needs supplemental oxygen, they will

most often be tube fed) • Some can breathe on their own, just needing supplemental oxygen

Complication at 34-36 Weeks

• Almost as likely to survive as full-term babies• Low birth weight• 4.5-6lbs

• Complications• More risk for breathing, feeding, & body temperature regulation problems

Economics of Premature Babies

• Survivors born prematurely face a lifetime of complications and health issues • Premature birth is the #1 cause of death for babies• 500,000 in just America

• Because premature babies may have health problems, they’ll stay in the hospital longer initially, increasing the cost to take care of them• And they’ll have return visits for health issues down the road

$26.6 Billion is Spent on Premies/Year• $16.9 billion in medical and health care costs for the baby• $1.9 billion in labor and delivery costs for the mother• $611 million for early intervention services • Programs for children from birth-3 with disabilities and developmental delays• Help children learn physical, thinking, communicating, social, self-help skills

• $1.1 billion for special education services • Specially designed for children with disabilities ages 3-21• Help with development and learning• At school, home, or in hospitals

• $5.7 billion in lost work and pay for people born premature

Schooling

• 1/3 children will need special school services at some point• The Institute of Medicine estimate that $2,200 is spent per year per

child• $2,200x450,000= $990,000,000/year

Work Cited

• http://www.mayoclinic.org/diseases-conditions/premature-birth/basics/complications/con-20020050

• http://www.babycenter.com/0_whats-the-outlook-for-premature-babies-born-before-28-31-33_10300031.bc?page=3

• http://www.babymed.com/prematurity/pregnancy-viability-what-does-it-mean

• http://www.marchofdimes.org/mission/the-economic-and-societal-costs.aspx#

• http://www.ncbi.nlm.nih.gov/books/NBK11358/

• http://www.mayoclinic.org

• http://www.cdc.gov

• http://www.nlm.nih.gov

• webmd.com

• babycenter.com

• http://americanpregnancy.org/labor-and-birth/premature-labor/

• http://www.mayoclinic.org/diseases-conditions/preterm-labor/basics/prevention/con-20035359