Premature babies: the basics

Britain has the highest rate of premature births in Europe – more than 45 000 per year. But there’s a huge difference between the odds of healthy survival at 37 weeks than at, say, 24 weeks. Gavin Evans, answers some of the most common questions….

Q: When is a baby defined as premature?

A: Full-term is 38 to 42 weeks, so babies born before that are premature (35 – 37 weeks: moderately; 29 – 34 weeks: very; 24 – 28 weeks: extremely)

Q: How common is premature birth?

A: More than 10 per cent of all births – and half of twin births - are premature.

Q: What causes premature birth?

A: The most common direct cause is the premature rupture of the membranes (known as PROM). If that happens your partner may be given antibiotics to delay birth or prevent infection.

Aside from twins and previous premature births, medical issues prompting premature birth could include:

  • vaginal infection
  • excessive amniotic fluid
  • cervical problems
  • uterine infection
  • problems with the placenta
  • pre eclampsia

Other factors include:

  • diabetes
  • smoking
  • excessive alcohol intake
  • poor nutrition
  • extreme stress

Q: What are the chances of survival?

A: From 32 weeks most babies survive without the help of technology but the chances of survival fall rapidly with extremely premature babies:

  • 26 weeks (80 per cent)
  • 25 weeks (50 per cent)
  • 24 weeks (40 per cent)
  • 23 weeks (17 per cent)

These figures are for intact survival rates (i.e. born with no major physical or mental deficits).

Q: How long is the hospital stay?

A: Until their original due date (three months for a baby born at 26 weeks). From 35 to 38 weeks they may be able to feed and maintain their own body temperature but are susceptible to infection and more likely to have jaundice.

Before 32 weeks they’re too immature to feed from the bottle, so breast milk can be pumped and fed to the baby through a tube (premature babies receiving breast milk do better) and they’ll need to be on a ventilator because their lungs have not matured.

Baby's home: what next

Q: How should I relate to my premature baby?

A: Premature babies can, and should, be touched, cuddled and talked to – even those in incubators (provided you wash and dry your hands thoroughly first).

Q: Will there be long-term medical problems?

A: A premature baby has less time to develop in the womb and so there’s a higher risk. However, about two-thirds of premature babies grow up to be completely normal or have only mild to moderate problems.

The risk relates to how premature they are and whether they’re boys or girls (boys are more likely to be affected). Before 26 weeks only about 20 per cent grow up with no medical problems; over 20 per cent have severe disability (cerebral palsy without being able to walk, learning difficulties, blindness, deafness); nearly a quarter have moderate disability and 34 per cent have mild disability.

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