Unexpectedly Early: Supporting Premature Babies & Their Families

Timing is everything when it comes to a pregnancy.

From choosing an opportune time in your life to plan a pregnancy, to using an ovulation calendar to determine a window when fertility is highest, to calculating the date of conception and due date, to impatiently waiting for your new bundle to arrive, keeping track of time is an important part of the process.

Of course, when it comes to children, all parents quickly learn to expect the unexpected. That first lesson often occurs if the baby arrives earlier (or later) than anticipated. If the baby arrives a few weeks before the due date or a couple weeks late, it is within a range typically associated with normal, healthy births. However, a baby born earlier than 37 weeks of pregnancy is at greater risk for complications including lifelong health impacts.

In honour of World Prematurity Month, this blog post explores what prematurity means, outlines some of the challenges premature babies face, notes some interventions that can lead to better outcomes, and explains how the Canadian Premature Baby Foundation is providing education, support and advocacies for these children and their families.

Defining Prematurity.

On average, pregnancies last between 37 to 42 weeks. Any child born before the 37th week of gestation is deemed to be premature. However, subcategories are used to determine the degree of the prematurity. Categories of prematurity include:

• extremely preterm if under 28 weeks of gestation (some sources use 25 weeks as the upper limit)
• very preterm if between 28 to less than 32 weeks of gestation
• moderately preterm if between 32 to less than 34 weeks of gestation
• late preterm if between 34 to less than 37 weeks of gestation

Generally, babies born after 24 weeks of pregnancy have a greater than 50% chance of survival. The likelihood of survival grows with each additional week of gestation and by the 28th week of pregnancy between 80 to 90 percent of premature babies survive.

Health Risks.

There are numerous factors which influence both the chance of survival and the risk of long-term health problems for premature babies - especially if they are extremely premature. These include:

• maternal age and health
• complications during pregnancy (preeclampsia or placental abruption)
• the baby’s sex (girls have better survival rates than boys)
• the baby’s birth weight (the higher, the better, for odds of survival)
• multiple births (singleton babies have higher survival rates)
• gestational age (about 40 percent of babies born before 24 weeks have long-term health problems compared to only 10 percent born at 28 weeks)

A premature baby may be at increased risk of both short-term and long-term complications and health issues.

In the short term, heart problems (hypertension and patent ductus arteriosus), breathing problems (apnea, respiratory distress syndrome, broncopulmonary dysplasia), brain hemorrhage, hypothermia, gastrointestinal problems (necrotizing enterocolitis), hypoglycemia (decreased sugar in the blood), immune system problems (high risk of infection and sepsis), and blood problems (anemia and jaundice) are possible.

In the long term, premature babies have a greater risk of developing chronic health issues including Cerebral Palsy, learning disabilities, vision and hearing problems, dental problems, and psycho-social issues and developmental delays.

Prevention.

Although the exact cause of premature births is unknown, good prenatal care which focuses on maternal health is advisable. Some known maternal risk factors include chronic conditions, being over or underweight, smoking or illicit drug use, certain infections, previous premature births, a multiples pregnancy, less than six months between pregnancies, conception through in vitro fertilization, problems with the uterus, cervix or placenta, multiple miscarriages or abortions, physical injury or trauma, and stress.

Progesterone (hormone) supplements and cervical cerclage (stitching the cervix closed to provide extra support for the uterus) have been used as preventative measures for people with a history of premature births or people with a short cervix.

In some cases premature labour will stop on its own but in many cases delivery may be necessary. In these cases health care providers will administer medications to help prepare the premature infant cope with life outside the womb. These medications include corticosteroids (to help speed up development of the lungs, brain, and organs), magnesium sulfate (may reduce the risk of cerebral palsy), and tocolytics (to delay the labour by a few days allowing the other medications to work and transfer to another hospital with experience caring for premature infants).

Raising Awareness.

Every year more than 30,000 children are born prematurely in Canada. Although, thankfully, many will not experience any short-term or long-term health issues as a result of their early birth, the stress of a premature birth on both the parents and baby is significant. For children who do suffer from complications or acquire a disability as a result of prematurity, the road ahead can be full of challenges. Many preemies and their families spend months in a hospital Neonatal Intensive Care Unit (NICU).

I’m proud to serve on the Canadian Premature Babies Foundation (CPBF) board - especially as we celebrate our 10th anniversary during November’s World Prematurity Month. CBPF supports preemies and their families through peer support programs, resources for families and health care processionals as well and supporting research leading to improved outcomes and experiences for these babies and their families. To help raise awareness of prematurity, CPBF is marking World Prematurity Day on November 17 by hosting ”Live Preemie Chats” -- live streamed conversations between parents of preemies and medical care providers. We are also thrilled to launch Preemi – the first toy designed exclusively for premature babies. You can order and get on the waitlist though the website. Other notable events and campaigns this month include:

• an illumination monument campaign.
• a fundraising campaign promoted by Pampers.
• posters and buttons to be distributed to NICUs across Canada.
• a social media campaign.
• a speaking engagement at Niagara Region Public Health.
• and much more.

Full-circle care.

Gluckstein Personal Injury Lawyers takes great pride in giving back to the communities we serve by supporting organizations such as CPBF through funding partnerships and/or by volunteering our time as individuals.

To learn more about our commitment to full-circle client care, contact us today.