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A baby born before 37 weeks of pregnancy is considered premature, that is, born before complete maturity. Slightly fewer than 12 percent of all babies are premature. Overall, the rate of premature births is rising, mainly due to the large numbers of multiple births in recent years. Twins and other multiples are about six times more likely to be premature than single birth babies. The rate of premature single births is slightly increasing each year.
According to the National Center for Health Statistics, about 13 percent of babies born in the US are born preterm, or before 37 completed weeks of pregnancy. Of all babies:
Other terms often used for prematurity are preterm and "preemie." Many premature babies also weigh less than 2,500 grams (5.5 pounds) and may be referred to as low birthweight (LBW).
Premature infants born between 34 and 37 weeks of pregnancy are often called late preterm or near-term infants. Late preterm infants are often much larger than very premature infants but may only be slightly smaller than full-term infants.
Late preterm babies usually appear healthy at birth but may have more difficulties adapting than full-term babies. Because of their smaller size, they may have trouble maintaining their body temperature. They often have difficulty with breastfeeding and bottle feeding, and may need to eat more frequently. They usually require more sleep and may even sleep through a feeding, which means they miss much-needed calories.
Late preterm infants may also have breathing difficulties, although these are often identified before the infants go home from the hospital. These infants are also at higher risk for infections and jaundice, and should be watched for signs of these conditions. Late preterm infants should be seen by a care provider within the first one or two days after going home from the hospital.
There are many factors linked to premature birth. Some directly cause early labor and birth, while others can make the mother or baby sick and require early delivery. The following factors may contribute to a premature birth:
Premature babies are born before their bodies and organ systems have completely matured. These babies are often small, with low birthweight (less than 2,500 grams or 5 ½ pounds), and they may need help breathing, eating, fighting infection, and staying warm. Very premature babies, those born before 28 weeks, are especially vulnerable. Many of their organs may not be ready for life outside the mother's uterus and may be too immature to function well.
Some of the problems premature babies may experience include:
Premature babies can have long-term health problems as well. Generally, the more premature the baby, the more serious and long lasting are the health problems.
The following are the most common characteristics of a premature baby. However, each baby may show different characteristics of the condition. Characteristics may include:
The characteristics of prematurity may resemble other conditions or medical problems. Always consult your baby's physician for a diagnosis.
Specific treatment for prematurity will be determined by your baby's physician based on:
Treatment may include:
Premature babies usually need care in a special nursery called the Neonatal Intensive Care Unit (NICU). The NICU combines advanced technology and trained health professionals to provide specialized care for the tiniest patients. The NICU team is led by a neonatologist, who is a pediatrician with additional training in the care of sick and premature babies.
Care of premature babies may also include:
Premature babies often need time to "catch up" in both development and growth. In the hospital, this catch-up time may involve learning to eat and sleep, as well as steadily gaining weight. Depending on their condition, premature babies often stay in the hospital until they reach the pregnancy due date.
If a baby was transferred to another hospital for specialized NICU care, he/she may be transferred back to the "home" hospital once the condition is stable.
Consult your baby's physician for information about the specific criteria for discharge of premature babies at your hospital. General goals for discharge may include the following:
Before discharge, premature babies also need an eye examination and hearing test to check for problems related to prematurity. Parents need information about follow-up visits with the pediatrician for baby care and immunizations. Many hospitals have special follow-up healthcare programs for premature and low birthweight babies.
Even though they are otherwise ready for discharge, some babies continue to have special needs such as extra oxygen or tube feedings. With instruction and the right equipment, these babies are often able to be cared for at home by parents. A hospital social worker can often help coordinate discharge plans when special care is needed.
Ask your baby's physician about a "trial run" overnight stay in a parenting room at the hospital before your baby is discharged. This can help you adjust to caring for your baby while healthcare providers are nearby for help and reassurance. Parents may also feel more confident taking their baby home when they have been given instructions in infant CPR (cardiopulmonary resuscitation) and infant safety.
Because of the tremendous advances in the care of sick and premature babies, more and more babies are surviving despite being born early and being very small. But prevention of early birth is the best way of promoting good health for babies.
Prenatal care is a key factor in preventing preterm births and low birthweight babies. At prenatal visits, the health of both mother and fetus can be checked. Because maternal nutrition and weight gain are linked with fetal weight gain and birthweight, eating a healthy diet and gaining weight in pregnancy are essential. Prenatal care is also important in identifying problems and lifestyles that can increase the risks for preterm labor and birth. Some ways to help prevent prematurity and to provide the best care for premature babies may include the following: