Premature birth FAQ: all about your prematurely born baby

Filed under: Your Pregnancy

We often get questions from our readers about the causes of premature birth, when a baby is considered "viable" or "full term," and what happens next when you are faced with a premature delivery, so we are taking the time to research the answers to your top questions. Below you'll find answers from some of the leading experts on the Internet. As with any advice you find here or elsewhere on the 'net, you should first consult your health care provider and do your own research. If you've got additions, comments, links, questions or any feedback feel free to post a comment (comment link is on the bottom of this post).

Frequently Asked Questions:

1. What does "premature" mean, anyway?
2. What is the earliest a hospital will deliver a baby?
3. What causes premature birth?
4. Can premature birth be prevented?
5. What are the dangers to a baby born early?
6. How many babies are born prematurely?
7. Where can I find other parents who have experienced the early delivery of their baby?

1. What does "premature" mean, anyway?
A woman's "due date" is set at 40 weeks past the first day of her last menstrual period, and the number of weeks past the start date is known as the baby's gestational age. According to KidsHealth, any baby born less than 37 weeks' gestational age is premature. The NIH says that babies born before this time "are not fully grown" and "may not be able to survive outside the womb," although 90% of babies born at 800 grams or more (not quite 2 pounds) survive without major complications.

2. What is the earliest a doctor will deliver a baby?
Babies born earlier than 26 weeks' gestation have a much higher rate of complications, according to the March of Dimes, and Best Doctors says that only babies born after 24 weeks of gestation have a chance of survival. However, Best Doctors reports, the chances of survival at 24 weeks are 60%, and the chances of having a handicap due to the early birth are 60%, as well. Babies born at 26 weeks have a 95% chance of survival and their handicap risk drops to 40%; just two more weeks makes a big difference in your baby's outlook.

However, your hospital's policies may differ; information at Penn Health indicates that babies can survive as early as 23 weeks, although the survival rate increases by 3-4% per additional day of gestation between 23 and 24 weeks.

3. What causes premature birth?
Premature birth is typically caused by "preterm labor," and KidsHealth lists many causes of preterm delivery, which can range from "the mother's lifestyle choices during pregnancy: smoking, drinking alcohol, using drugs, eating poorly, not gaining enough weight, and exposure to physical stress" to causes outside a mother's control, such as hormonal imbalance, an abnormality of the uterus, a chronic illness, or an infection.

BabyCenter has a comprehensive list of causes, including: genital tract infections like chlamydia and bacterial vaginosis; placenta previa or placental abruption; uterus abnormalities like cervical insufficiency; having an excessively large uterus; chronic maternal illnesses, like diabetes, sickle cell anemia, severe asthma, lupus, inflammatory bowel disease, or chronic active hepatitis; kidney infection; abdominal surgery; trauma to the abdomen; and periodontitis. Phew, that's a lot of things to worry about.

Physicians are frustrated with the recent rise in the rate of premature births, according to the Seattle Times, and last winter the March of Dimes held a symposium to discuss the problem. One major cause, the article states, is stress - scientists have made a clear link between extreme maternal stress and preterm labor.

4. Can premature birth be prevented?
CBS News reports that there is really no way to prevent premature birth - but sometimes, it can be delayed. Whether premature birth can be delayed all depends on what the underlying cause is. Sometimes premature labor caused by an infection can be prevented, simply by treating the infection (usually with antibiotics).

Mercola reports that preterm labor can sometimes be prevented (if it hasn't already begun) with certain hormones; or delayed a few days with a drug category called tocolytics (you've probably heard of the common terbutaline). Often, bedrest is prescribed to delay preterm labor if the waters haven't yet broken, but there is some controversy over whether this is effective.

5. What are the dangers to a baby born early?
The dangers to an prematurely born infant are numerous, but typically vary based on the baby's gestational age and weight at delivery. Penn Health reports that, statistically, "the chance for a premature baby's survival is based on the baby's age, weight, ability to breathe, and how many other complications are present." They list possible complications, which include jaundice, respiratory distress syndrome, anemia, apnea, infection, blindness, low blood pressure, brain hemorrhage, and intestine and bowel infections.

PregnancyWeekly lists other problems associated with extreme premature births (between 23 and 25 weeks), such as cerebral palsy, developmental delays, and seizures. What is known for certain is that every day longer a baby can develop in utero, his chances of complications decreases significantly.

6. How many babies are born prematurely?
The March of Dimes reports that one in eight babies in the United States are born preterm. Of those, 84% are born between 32-36 weeks' gestation; 10% are born between 28-31 weeks' gestation, and 6% are born at less than 28 weeks' gestation.

7. Where can I find other parents who have experienced the early delivery of their baby?
We "know," virtually speaking, a lot of parents who've endured premature birth. Many of them can be found in the links and commenters to the births of Odin (25 weeks) and Charlie (30 weeks).

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AdviceMama Says:
Start by teaching him that it is safe to do so.