Premature infants are babies who are born before the 37th week of gestation. A premature birth shortens the time for development and maturation in the womb. The risk of complications increases the earlier the baby is born. The result is an increased risk of medical and developmental problems.
Immature Lungs
The major concern with a premature birth is respiratory system complications. The lack of surfactant, which is a lipoprotein that prevents the lungs from collapsing, causes respiratory distress syndrome. While in a neonatal intensive care unit, the premature infant receives supplemental oxygen. This is delivered through one or more of the following: an oxygen hood (which delivers oxygen to the baby), a ventilator (which maintains artificial respiration), continuous positive airway pressure (which delivers pressurized air and helps the baby to breathe on his own) or endotracheal intubation. Endotracheal intubation is the procedure of inserting a tube into the infant's trachea to maintain the airway and maintain artificial respiration. In severe cases, surfactant may be administered.
Bronchopulmonary dysplasia is a complication of the use of ventilator support for more than 28 days. The American Pregnancy Association explains that the constant pressure of ventilator support can damage the premature infant's underdeveloped lungs. Prognosis for recovery is good though recovery time is variable.
Pneumonia can occur in premature babies. It is an infection of the immature lungs causing inflammation that restricts the exchange of air. The consequence is an inadequate amount of oxygen to the body.
Episodes of apnea, which is the absence of breathing, can occur. Usually, a gentle tap or rub on the back will stimulate breathing.
Neurological Damage
There is an increased risk of bleeding in the brain for infants who are born at less than 34 weeks of gestation. The immature blood vessels can not tolerate the changes in circulation that occur during labor. According to the American Pregnancy Association, intracranial hemorrhage can occur in about a third of all babies who are born at 24 to 26 weeks of gestation. The Mayo Clinic reports that hydrocephalus, which is the accumulation of fluid in the brain, can occur in premature infants. Additional complications of prematurity include cerebral palsy, mental retardation and learning difficulties.
Immature Gastrointestinal System
The gastrointestinal system of the premature infant is immature and unable to absorb nutrients safely. Initial nutrients are delivered intravenously (through the vein).
As the premature infant appears stronger and is gaining weight, breast milk and formula are delivered through a feeding tube, a small tube which is inserted through the nose or mouth into the stomach.
Necrotizing enterocolitis is an infection of the intestinal mucosa and a complication of a premature birth. The cause is unknown. According to the National Institutes of Health website, medical experts think that a decrease in blood flow to the intestines interferes with the production of a protective mucus coating to the intestines. Another possible cause is bacteria in the intestines. Intravenous feedings and antibiotics are the treatments of choice.
Immature Heart Development
Patent ductus arteriosus is a cardiac disorder associated with premature births. A fetus produces prostaglandin E, which keeps the ductus arteriosus open. While in utero, an open ductus arteriosus allows blood to be diverted from the lungs into the aorta. At full term, the levels of prostaglandin E fall to prepare the mature lungs to function. In a premature birth, the prostaglandin E levels may not fall and the ductus arteriosus may remain open. Medication to cease or slow prostaglandin E production is the treatment.
