All you need to know about Premature Birth Complications

Short-term consequences of Premature Birth

The following complications can affect preterm babies in the first weeks after birth.

1. Jaundice in preterm babies

In this condition, the liver can’t get rid of bilirubin, which is a substance produced during the normal breakdown of RBCs. As a result, bilirubin accumulates in the baby’s blood and spreads into the tissues. While it is not a serious problem, it can cause bilirubin toxicity if the bilirubin levels get too high. Ask your healthcare provider for the baby’s bilirubin level.

Normal levels of bilirubin in a newborn should be under 5 mg/dL and while many preterm babies have bilirubin levels above that, it is dangerous if the level reaches above 15-20 mg/dl.

Treatment: The standard treatment for jaundice is phototherapy. This involves placing a baby under bright lights. 

2. Kidney disorders

Babies born prematurely, especially those born before 28 weeks don't have fully developed and functional kidneys. Hence, they are unable to filter out the waste from their bodies and may also experience a problem with producing urine.

Treatment: The most common and basic treatment are fluid restriction and salt restriction. Immature kidneys usually improve and have normal function within a few days. In some cases, they may also give more fluids so that substances like medications are not overly concentrated in the blood.

3. Breathing problems

This issue of breathing problems in premature babies are caused by an immature respiratory system. The lungs in preterm babies are immature and they often lack surfactant, a liquid that coats inside of the lungs and helps keep them open. Without the surfactant, lungs can’t expand and contract normally thereby increasing their risk for respiratory stress syndrome. Sometimes, the babies may also experience pauses in their breathing lasting for at least 20 seconds. They may also need to be put on ventilator which can increase their risk of developing bronchopulmonary dysplasia, a chronic lung condition.

Treatment: Being on a ventilator for an extended period of time may injure a baby’s lungs but it still may be necessary for the baby to receive continued oxygen therapy and ventilator support. Doctors may also use diuretic and inhaled medications.

4. Heart problems

Patent ductus arteriosus (PDA) is the most common heart condition affecting premature babies. It is the opening between two major blood vessels of the heart which normally closes soon after birth, but in premature babies, the ductus arteriosus may remain open (patent) instead. If this occurs, it can cause extra blood to be pumped through the lungs in the first days of life.

Treatment: Babies can be treated with medication and if it still remains open and symptomatic, an operation may be required to close the duct.

5. Brain problems

A common brain problem seen in preterm babies is excessive bleeding. Mild bleeding in the brain is usually not so dangerous, but when the bleeding is heavy the brain may get damaged. This may lead to either short-term or long-term brain problems causing some serious psychological effects of premature birth.

Treatment: To treat this, the doctor may prescribe medicines or if needed even perform surgery to drain out excess blood in the baby’s brain.

Long-term consequences of premature birth

While some premature babies may not face any health issues, some have a list of long-term consequences such as:

1. Vision problems

Preterm babies can experience vision problems because of blood clots inside their eyes which may lead to retina detachment and subsequent blindness. This can be treated with laser therapy or surgery, depending on severity of the condition. The child may also have vision impairment as he grows old and may require spectacles.

2. Hearing disability

Hearing disability is common in preterm babies and the baby may have partial or total hearing loss. The exact cause is yet unknown. Treatment for this includes – surgery, hearing aids, ear tubes or cochlear implant.

3. Cerebral palsy

Cerebral palsy happens due to an infection, poor blood flow, or a brain injury during pregnancy or after birth. It is a movement disorder that affects muscle tone, muscle coordination, movement, and balance.

While there is no cure for cerebral palsy, there are treatment options that can help improve any limitations. This includes – use of hearing aids, walking aids, and eyeglasses for assistance, medications to help prevent muscle spasms, and surgery to improve mobility.

4. Behavioural problems

Premature babies are more likely to develop behavioural problems as they grow old. This includes attention-deficit disorder (ADD) and attention-deficit/hyperactivity disorder (ADHD). To deal with this, along with medications creating a structured and consistent schedule can help kids with ADHD.

5. Chronic health problems

Preterm babies have a greater risk for developing chronic health problems as they have low immunity and are more susceptible to infections. There’s also an increased risk of sudden infant death syndrome (SIDS) among premature infants.