Preterm, or premature birth, where a baby is born before 37 weeks of pregnancy, affects around 8% of pregnancies in Canada. There are health problems which may affect premature babies soon after birth, as they go through childhood and also as adults. There has been significant work to help babies who are born early and this has helped reduce the chances of preterm babies being affected by long-term health conditions.
A collaborative program in Canada, involving the doctors, nurses and parents who care for premature babies, studied how implementing changes on a national level can affect the health of babies born prematurely over time. This program encouraged communication between those caring for pregnant women facing preterm delivery and the neonatal units who look after premature babies after birth.
What are the risks of prematurity and what can be done to improve outcomes?
Between 2004 and 2017, significant changes in medical care for babies were made and their effect was measured. The changes that were made included giving women steroids who were about to deliver prematurely, treating premature babies with a medication called surfactant and ensuring that babies maintained an ideal temperature after birth. The program also advised on how best to provide care to premature babies after birth, guided doctors and nurses to avoid using a ventilator if possible, gave guidance on how to support babies with their feeding and nutrition and encouraged developmental care.
The research showed that the survival of very premature babies improved by 25% during this time and reduced the chances of premature babies being affected by:
- bronchopulmonary dysplasia – this is a severe chronic lung disease which can make a baby born prematurely more prone to developing asthma and or suffering pneumonia later in life;
- retinopathy of prematurity – this is a condition which affects the eyes and, in turn, can cause blindness;
- necrotizing enterocolitis – this is a condition causing infection and inflammation of the bowel which can cause severe damage and ongoing problems with digestion, growth and development.
The effect of the environment and level of support provided to families caring for premature babies has also been shown to impact upon their health and development. A study in Rhode Island, Providence compared babies who were cared for in an open bay to those in a single-family room and found that the premature babies cared for in a single-family room had better developmental scores between 18 months and 2 years of age. They also found that the volume of human milk produced by the mothers who were nursing babies in a single-family room was higher. An increased volume of human milk has been shown in other studies to impact positively upon the health of premature babies.
The development of premature babies may be affected if they have cerebral palsy and premature babies are at an increased risk of having this condition. As we reported recently, new research has shown that babies born prematurely to mothers who have been given magnesium sulfate shortly before birth had 30% less risk of developing cerebral palsy. This study and the research described above show the positive impact that the care, medication and support provided to premature babies and their mothers can have.
The timely administration of these interventions coupled with careful assessment and monitoring can make the difference between a premature baby who is able to overcome the risks of prematurity and the baby who suffers permanent health and developmental challenges that last a lifetime. If you have questions about whether your premature baby received appropriate medical care consistent with the standard of care in Canada, feel free to contact us for a free consultation. We are here to help.