By Dr Ramani Ranjan
A baby is termed ‘preterm’ when it is born ahead of 37 weeks of pregnancy. This may result in many complications as their organs do not develop completely by that period. It may also lead to long-term intellectual and developmental disabilities and problems with their lungs, brain, eyes, and other organs.
Depending upon how early they are born and to support these babies, they may need Neonatal Intensive Care Unit (NICU) care where we try to mimic an environment similar to the mother’s womb.
The preterm birth complications are effectively dealt with in the NICU.
According to the World Health Organization (WHO), 30 million newborns will die within the first 28 days of life between 2017 and 2030 because of the neonatal period. The first 28 days of life carry the highest risk of mortality per day than any other period during childhood. Despite a decline in Infant Mortality Rate (IMR), neonatal mortality has remained mostly static. It is, therefore, essential that neonates are provided utmost care at the first month of life so that neonatal deaths on account of asphyxia, infection, and preterm births are prevented. Under the National Rural Health Mission, several initiatives have been undertaken to accelerate the pace of reduction of child mortality. The introduction of advanced neonatal care units with latest machines including high-end ventilator and CPAP machines in maternity hospitals is a step towards it.
After discharge from NICU preterm babies need follow-up, as they are prone to intellectual and developmental disabilities.
Preterm birth leads to many problems with how the brain works. They can cause a person to have trouble or delays in:
Long-term conditions linked to premature birth include:
Cerebral Palsy: It is a group of disorders that affects the movement and posture of the body. It may affect even babies born at term, but incidence is more in premature babies.
Bronchopulmonary dysplasia (BPD): It is a lung disease that mostly happens to preterm babies. It’s also common in babies who use some sort of breathing machines. In this condition, babies’ lungs suffer chronic inflammation. They are also more prone to pneumonia. However, with age, BPD gets better but they may have an increased tendency for asthma or bronchitis throughout their life.
Problems in the intestine: This is generally caused by necrotizing enterocolitis (also called NEC), a condition where the intestines become infected and can begin to die. This disease has a very serious implication on a newborn’s health. Surgery may be needed to treat these problems. Some babies undergo surgery to remove part of the intestine that is diseased.
Vision problems, like retinopathy of prematurity (also called ROP): This disease affects the eyes of many premature babies. In this condition, a baby’s retinas do not fully develop in the weeks after birth. ROP usually affects both eyes. Children born prematurely are more likely to have this issue than children born on time.
Poor mental health: Premature babies may more likely have anxiety or depression later in life as they mostly go through many bodily issues.
(The writer is a consultant pediatrician & neonatologist, Motherhood Hospital, Noida)