Quizzing them, Bolton discovered that many had been born before 32 weeks. For more insight, she got in touch with Marlow, who had also become concerned about lung function as the EPICure participants aged.
Alterations in lung function are a key predictor of cardiovascular disease, the leading cause of death around the world. Ventilators, high oxygen levels, inflammation and infection can further damage the immature lungs, leading to low lung function and long-term breathing problems, as Bolton, Marlow and their colleagues showed in a study of year-olds 9.
Treatments for premature babies have improved in recent decades, but survival rates vary by age and country. VICS research backs up the cardiovascular concerns: researchers have observed diminished airflow in 8-year-olds, worsening as they aged 10 , as well as high blood pressure in young adults At Sainte-Justine, researchers have also noticed that young adults who were born at 28 weeks or less are at nearly three times the usual risk of having high blood pressure The researchers figured they would try medications to control it.
But their patient advisory board members had other ideas — they wanted to try lifestyle interventions first. The scientists were pessimistic as they began a pilot study of a week exercise programme. They thought that the cardiovascular risk factors would be unchangeable. Preliminary results indicate that they were wrong; the young adults are improving with exercise. Girard-Bock says the data motivate her to eat healthily and stay active. For babies born prematurely, the first weeks and months of life are still the most treacherous.
Dozens of clinical trials are in progress for prematurity and associated complications, some testing different nutritional formulas or improving parental support, and others targeting specific issues that lead to disability later on: underdeveloped lungs, brain bleeds and altered eye development. Rates of a chronic lung condition that often affects premature babies halved, and babies were somewhat less likely to have a severe brain haemorrhage in their earliest months.
Another concern is visual impairment. Retina development halts prematurely when babies born early begin breathing oxygen. Later it restarts, but preterm babies might then make too much of a growth factor called VEGF, causing over-proliferation of blood vessels in the eye, a disorder known as retinopathy.
Some common drugs might also be of use: paracetamol acetaminophen , for example, lowers levels of biomolecules called prostaglandins, and this seems to encourage a key fetal vein in the lungs to close, preventing fluid from entering the lungs But among the most promising treatment programmes, some neonatologists say, are social interventions to help families after they leave the hospital. For parents, it can be nerve-racking to go it alone after depending on a team of specialists for months, and lack of parental confidence has been linked to parental depression and difficulties with behaviour and social development in their growing children.
There, families are placed in private rooms, instead of sharing a large bay as happens in many NICUs. For mothers with postnatal depression, the hospital offers care from psychologists and specialist nurses. The results have been significant, says Vohr. At 2 years old, children from the single-family rooms scored higher on cognitive and language tests After Transition Home Plus began, babies discharged from the NICU had lower health-care costs and fewer hospital visits — issues that are of great concern for premature infants With these types of novel intervention, and the long-term data that continue to pour out of studies, doctors can make better predictions than ever before about how extremely premature infants will fare.
Although these individuals face complications, many will thrive. Alsadik, for one, intends to be a success story. Despite her difficult start in life, she does well academically, and plans to become a neonatologist.
Soll, R. Cochrane Database Syst. CD Article Google Scholar. British Association of Perinatal Medicine. Google Scholar. Crump, C. Pediatrics , e PubMed Article Google Scholar. Garfield, C. JAMA Pediatr. Saigal, S. Pediatrics , — Gire, C. Bolton, C. For instance, one study found that the overall rates for survival and for survival without impairment ranged from 5.
For 26 weeks of gestation, the percentages were significantly higher with a survival rate of It's also important to note that these rates are heavily dependent on a multitude of factors, including why the baby is born early and where the baby is cared for.
Very preterm births account for approximately 1. To provide a better idea of how early deliveries are categorized, doctors break down the gestational week ranges as follows:. Note that the vast majority of premature births take place during the late preterm period.
A periviable birth is a birth that takes place near the limit of viability—usually defined as between 23 and 26 weeks gestation. Birth before 23 weeks is usually considered previable, which means there is virtually no chance of survival. Multiple factors can play into whether or not a baby will survive a premature birth, including:.
As such, babies who are born very prematurely and survive face high odds of having some level of long-term effects. The severity of these effects depends on many factors, including the need for and types of treatment received. Typically, the more intense the life-saving treatments, the greater the risk factors for these extremely small and fragile babies. However, it is difficult to tell precisely which babies will have problems and how severe these problems will be later in life.
Some common long-term effects of being born very prematurely include:. If you expect to deliver an extremely premature baby, start a conversation with the doctors who will be caring for your baby about what type of resuscitation you would want for your child at which gestational ages.
This is undoubtably a difficult situation to face. However, considering these issues before they are happening can give you a chance to ask all the pertinent questions and think through these tough decisions before they need to be made. Among some questions parents who are facing a pre-term birth or who unexpectedly have one should ask:.
There are so many variables to consider when delivering a preterm baby for both parents and medical professionals. It is not merely a discussion of whether the baby survives the birth, but what the long-term outcomes for your baby are. If your baby was born prematurely or you expect your baby to be born prematurely, talk at length with your baby's doctor so you can be as prepared as possible and get the support you may need.
Parental support groups are invaluable to both yourself and others. Get diet and wellness tips delivered to your inbox. Outcomes for extremely premature infants. Anesth Analg. Very premature births: Dilemmas and management.
Part 1. Outcome of infants born before 28 weeks of postmenstrual age, and definition of a gray zone. Arch Pediatr. American College of Obstetricians and Gynecologists. Periviable birth. Published June Between-hospital variation in treatment and outcomes in extremely preterm infants. More: Premature birthrate increases in Mississippi, according to March of Dimes. Ahmad, lead author on a study published in Pediatrics about the girl's development, said the girl's situation shouldn't serve as an example of premature health at 21 or 22 weeks gestation, because more research needs to be done.
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