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What is a premature birth? -

The World Health Organization defines a premature birth, or preterm birth, as babies born alive before 37 weeks of pregnancy are completed.

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Preterm sub-categories -

There are sub-categories of premature birth, based on gestational age: extremely preterm (less than 28 weeks); very preterm (28 to 32 weeks); and moderate to late preterm (32 to 37 weeks). Pictured is an ultrasound of a fetus at 12 weeks.

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Late preterm stage -

Most premature births occur in the late preterm stage (32 to 37 weeks). Pictured is an ultrasound profile of a baby fetus face and chest at 20 weeks.

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Risk factors governing preterm birth -

The specific cause of premature birth is unknown. However, there are known risk factors of preterm delivery. These include multiple pregnancies, having a previous premature birth, and intervals of less than six months between pregnancies.

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Smoking while pregnant -

Smoking or using illicit substances during pregnancy can increase your chances of preterm delivery.

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Obesity -

According to findings from the Stanford University School of Medicine, obesity before pregnancy is linked to earliest preterm births. It should also be noted that being undernourished is also detrimental to a full-term pregnancy.

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In vitro fertilization -

Conceiving through in vitro fertilization (IVF) can play a role in premature birth, although doctors are not exactly sure why IVF babies tend to be born earlier than other babies.

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Stress -

Never underestimate the effects that undue stress can have on a pregnancy. The loss of a loved one, or experiencing physical trauma can induce a premature birth.

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Diabetes -

Chronic medical conditions such as diabetes are other risk factors of premature delivery.

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High blood pressure -

So too is high blood pressure.

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Genetic factors -

Researchers have determined that Black women have a threefold higher rate of birth at 20 to 34 weeks of gestation compared to white women, suggesting that genetic factors are at play. But no pregnant woman can rule out a preterm birth, and in fact many women who have a preterm birth have no known risk factors.

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Short- and long-term effects of preterm birth -

As a result of their early entry into the world, preterm babies are exposed to a host of health complications.

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Respiratory distress -

In the first weeks, the short-term complications of premature birth may include respiratory distress. A premature baby may have trouble breathing due to an immature respiratory system.

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Breathing problems -

Serious breathing problems are common in preterm infants and may even require that the baby be intubated and placed on life support (ventilators).

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Brain problems -

Another serious problem of premature birth is an immature brain. The brain is the last major organ to mature in babies. The earlier a baby is born, the greater the risk of bleeding in the brain, known as an intraventricular hemorrhage (IVH). Most cases of IVH are mild and resolve with little or no impact. However, a larger, more prolonged bleed can cause permanent brain injury. Pictured is a mobile functional exploration unit. A nurse intervenes in a neonatal service to carry out a checkup EEG on a premature baby. The EEG enables the development of the brain to be monitored.

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Heart problems -

The most common heart problems preterm infants face include patent ductus arteriosus—an unclosed hole in the aorta. Low blood pressure (hypotension) can also affect coronary function.

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Temperature control problems -

When babies are born less than 32 weeks, they need to be cared for as if they are still in the womb. Premature babies can lose body heat rapidly, and hypothermia can quickly set in. Hypothermia in a preterm baby can result in breathing problems and low blood sugar levels (hypoglycemia). That's why smaller premature infants require additional heat from an incubator.

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Blood problems -

Preterm infants are prone to blood problems. Anemia is a common condition, brought on by a lack of red blood cells. Newborn jaundice occurs because the baby's blood has an excess of bilirubin, a yellow-colored substance, acquired as a result of an immature liver. Newborn jaundice, however, is fairy common—about three in five babies (60%) have jaundice. Pictured is a premature infant having treatment for jaundice under ultraviolet light in an incubator.

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Metabolism problems -

Premature birth can play havoc with the metabolic system. Some preterm infants may develop hypoglycemia, induced by smaller stores of stockpiled glucose. Similarly, premature babies also have more difficulty converting their stored glucose into more usable, active forms of glucose.

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Gastrointestinal problems -

The more premature a baby, the more likely it is to develop gastrointestinal problems. While the gastrointestinal tract (GI) is fully formed at 20 weeks, it is nowhere near ready to work properly. As a result, complications such as necrotizing enterocolitis can occur, which is when the cells lining the cell wall are injured.

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Immune system problems -

A familiar condition in preterm babies is a suppressed immune system. This can lead to a higher risk of infection, which is a serious problem given that infection can quickly spread to the bloodstream, which can result in sepsis, a life-threatening medical emergency.

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Long-term complications -

The long-term complications of premature birth are sadly numerous. Among the more serious is cerebral palsy. This is a disorder of movement that affects muscle tone, muscle coordination, movement, and balance. Infection, poor blood flow, or brain injury during pregnancy or after birth are all contributory factors. There is no cure for the condition.

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Cerebral palsy -

Pictured is a doctor conducting an ultrasound examination of the head and brain of a newborn baby.

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Impaired learning -

Preterm infants are more likely to have lower intelligence quotients and academic achievement scores, a result of impaired cognitive functions, which can be intellectual, developmental, or both.

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Behavioral problems -

Similarly, children born prematurely more often experience behavioral and psychological problems, and overall development delays.

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Hearing problems -

Another consequence of a premature birth is hearing loss. In extreme cases, hearing loss can be permanent, and the exact cause is not clear. Some studies suggest that it might be as a result of the mother having had an infection during pregnancy. An audio check should always be carried out on premature babies before being allowed home.

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Vision problems -

Potential sensory problems extend to impaired vision. Preterm infants are at risk of what's known as retinopathy of prematurity (ROP), a disease that occurs when blood vessels swell and overgrow in the light-sensitive layer of nerves at the back of the eye (retina). ROP usually goes away as an infant grows, but if undetected or left untreated it can lead to permanent blindness.

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Dental problems -

While of course not immediately apparent, dental issues can affect a preterm baby later in life. Common complaints include delayed tooth growth, tooth discoloration, or improper alignment.

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Chronic health issues -

Babies born prematurely will very likely experience a greater share of chronic health problems than those born full-term. They are more susceptible to infection, might experience difficulty feeding, and conditions like asthma could follow them into childhood and beyond.

Sources: (World Health Organization) (Stanford Medicine) (Very Well Family) (Med Page Today) (Mayo Clinic) (SickKids) (Healthline) (American Academy of Ophthalmology)

See also: 60 ways to care for your pregnant partner

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