11.01.2012

aware // prematurity

November is Prematurity Awareness month.  At this time, just last year, my little boys were fighting for their lives in the NICU.  Though the hardest part is behind them, the effects of their premature birth are lifelong.  Before I had preemies, I knew nothing about premature birth, what causes it, what it can cause, etc.  In honor of Aiden & Ryan and all the other babies born too soon, let's discuss the number one killer of newborns.  (I know, my choice of wording is morbid.  But it is the truth.)

Preterm or premature birth is defined as the birth of a baby at less than 37 weeks gestational age.  Babies born before 26 weeks are known as micropreemies.  

What causes premature birth?

1. Infections/inflammation, such as a urinary tract infections or inflammation of the fetal membranes
2. Maternal or fetal stress
3. Bleeding, such as a placental abruption where the placenta peels aways from the uterine lining (which is why A&R were ultimately delivered)
4. Stretching of the uterus because of the presence of two of more babies, excessive amounts of amniotic fluid, etc.

The above are all causes of spontaneous labor: contractions begin or there is premature rupture of membranes (breaking of water).

There is also a condition known as Pre-Eclampsia (extremely high blood pressure), where it is imperative that baby is delivered immediately in order to save the lives of both mother and baby.  

Who is at risk?

1. Women who have had previous preterm birth
2. Women who are pregnant with more than one child
3. Women with cervical or uterine abnormalities
4. Women with certain lifestyles factors:  smoking, drinking, exposure to domestic violence, high levels of stress, etc.
5.  Women with certain medical conditions: diabetes, clotting disorders, obesity, etc.

Are there treatments available to prevent premature birth?

There are certain medications available, such as progesterone, that may be administered to women at risk for premature birth.  However, they must meet certain requirements and even then there is no guarantee.  Women who have had previous premature rupture of membranes may be treated with antibiotics to prevent it from occurring again.

What complications does the newborn face?

1. Respiratory distress sydrome
2. Bleeding in the brain (IVH) which can cause brain damage (This is what caused Hydrocephalus for our boys)
3. Patent ductus arteriosis which, if left untreated, can lead to heart failure
4. Necrotizing enterocolitis (death of intestinal tissue)
5. Retinopaty of prematurity which can cause blindness

Often times the medications and surgeries used to treat the above conditions come with their own set of risks and complications.  

What does this mean for the child, long-term?

1. Autism
2. Intellectual disbilities
3. Cerebral palsy
4. Lung problems
5. Vision and hearing loss 

There are other issues that premature children face after leaving the NICU that aren't often discussed, including feeding issues and sensory processing disorders.

As evidenced by the information above, children who are born prematurely have far more serious obstacles to overcome than just eating and gaining weight.  There are major medical conditions and disorders that result from the circumstances surrounding their birth.  While I'm aware that most people don't recognize these issues due to the fact that they haven't been directly touched by prematurity like I have, I hope that the information found on my blog will shed some light and help spread information that otherwise might be overlooked.   

Sources:  www.MarchofDimes.com; www.preemiemomblog.blogspot.com




 







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