Preterm birth

Approximately eight to nine percent of all babies are born prematurely, so-called "preemies" – but what exactly is "premature"? There is an endless amount of information about preterm births and their causes. In this article, we have summarized the most common risk factors for preterm births, how you can prevent them, and how to best support your prematurely born child.

When is a birth considered premature?

is born before the 37th week of pregnancy. before the completion of the 37th week of pregnancy is born. Additionally, preterm infants are divided into three different groups based on their weight:

· Newborns with extremely low birth weight (under 1,000 grams)

· Newborns with very low birth weight (1,000 to 1,500 grams)

· Newborns with low birth weight (1,500 to 2,500 grams)

Only about one percent of all newborns weigh less than 1,500 grams. These babies have a significantly increased risk of complications. Long-term studies fortunately show that most preterm infants not only survive but lead a largely carefree life.

Causes and Risk Factors of Premature Births

There are various risk factors that increase the likelihood of a premature birth. Over the past ten years, the number of children with low birth weight has nearly doubled. There are different reasons for this: for example, an increasing number of pregnancies resulting from fertility treatments due to conception problems, which can prevent the embryo from implanting optimally. Or that more and more mothers are having babies at an older age. Additionally, also increase the risk of preterm birth, as they place greater stress on the cervix and placenta. Other possible risk factors include:

• Repeated miscarriages or preterm births

• Repeated surgeries on the uterus, such as curettages, myomectomy, and removal of parts of the cervix.

• Alcohol or nicotine consumption and drug use during pregnancy

• Maternal illnesses, especially vaginal infections, but also preeclampsia, HELLP syndrome, and diabetes mellitus

• Especially advanced or young maternal age

• Placental insufficiency , premature placental abruption or placenta previa

• Increased amniotic fluid production and overdistension of the uterus due to fetal malformations (for example, spina bifida)

Not least, premature labor can also be a warning sign from the baby – for example, due to a threatened under-supply through the placenta. Since so-called high-risk pregnancies are now closely monitored medically from the beginning, early and miscarriage can be prevented more and more often. Only 9.2 percent of all births in Germany are premature. Some risk factors, such as the risk of infection, can be positively influenced by you in consultation with your doctor. In any case, regular during pregnancy are important. They allow potential causes of premature birth to be identified early and treated promptly if necessary. Thanks to the intensive care and treatment available today, premature babies now also have the best chances of becoming healthy children.

Signs of a premature birth

A threatened premature birth is often announced by premature labor or the bursting der Amniotic sac In addition to these unmistakable symptoms, there may be other signs indicating that your baby could be on the way too early:

• Menstrual-like cramps

• Discharge (often foul-smelling and discolored) as a sign of infection

• Vaginal bleeding

• Loss of amniotic fluid

If you notice any of these signs, you should so Contact your gynecologist as soon as possible or go to the emergency room. Spotting in early pregnancy does not necessarily have to be alarming, but better safe than sorry! Your doctor will examine you and check whether your symptoms indicate a threatened preterm birth. Depending on your week of pregnancy, the heartbeat of your baby will be listened to using a CTG, and the baby's well-being will be assessed. Additionally, he or she will examine the position and structure of the placenta, the amount of amniotic fluid, and the length and opening of the cervix.

Depending on the results of the examination, treatment will then be initiated. In the case of an infection, for example, it can often be treated well locally. The natural immune flora can be supported or restored with antibiotics or antimycotics as well as so-called lactic acid bacteria. Before the 34th week of pregnancy, lung maturity in your baby can also be promoted through corticosteroid treatment if a birth is actually imminent after thorough testing. This is very important if a premature birth actually occurs. Most hospitals perform so-called fibronectin tests, which can predict or rule out a birth within the next 7-14 days with high probability. Fibronectin is a protein and component of the amniotic membranes, which can be detected very early in vaginal secretions, even before labor relevant contractions begin or a rupture of membranes occurs. With the help of these tests, it can also be decided whether active labor suppression or treatment for lung maturity is necessary. This can be important if there are no objective criteria, such as a shortening of the cervix or a rupture of membranes, that make these treatments necessary. You may be prescribed bed rest or labor-suppressing medication to prevent an early birth. Or – if your little explorer is already so far along – preparations for birth are made. In the case of a premature birth, delivery should, if possible, take place in a hospital with neonatology to ensure your baby receives the best possible medical care after birth.

Challenges of premature children

The earlier your baby is born, the less developed its organs and immune system are, which therefore require support outside the protective womb. From the 23rd week of pregnancy, a baby is medically considered viable, and with each additional week, the risk of potential (late) consequences decreases. The birth weight also plays an important role when it comes to the health of premature infants: if a baby weighs over 2,500 grams at birth, its chances of survival are already 200 times higher than for a birth weight under 1,500 grams. Children born during this pregnancy phase are examined by their doctors especially intensively for neurological problems. Very small premature infants are also given particularly comprehensive medical care to prevent seizures, visual and hearing impairments, chronic lung problems, and developmental disorders.

An important milestone, the so-called Lung maturity, reached by babies with completed 34th week of pregnancy, prior to that, she can be medically supported with corticosteroid administration in case of threatened preterm labor ( RDS Prophylaxis ). In addition, prematurely born babies are given special care due to these potential secondary illnesses:

• Brain hemorrhages

• More frequent infections due to an immature immune system

• Intestinal inflammations, stomach pains, bleeding

• Retinopathy of prematurity (changes in the retina of the eye)

• Hyperglycemia (too low blood sugar level)

The goal of special monitoring here is to diagnose these conditions early and, if possible, even prevent them. You and your baby will be especially carefully cared for by medical professionals in the hospital after a premature birth. Don't hesitate to ask your questions!

Prevention

First and foremost: Premature births can rarely be influenced by the mother's behavior. The factors that trigger them are very diverse and highly individual. However, you should be strict regarding the consumption of nicotine/alcohol or other drugs – not only is there a proven significant risk of preterm birth, but also an increased risk of early or late miscarriages. Passive "smoking" also counts among the known risk factors. If you have concerns or worries, talk to your midwife or your doctor about it. In many cases, they can certainly reassure you. Regular check-ups are also very important so that risks can be identified early and treated if necessary. Especially if you have an increased – perhaps because you have experienced it before – you should discuss the possibility of more frequent check-ups with your doctor. Additionally, you can also inform your midwife early about your fears and concerns and attend regular check-ups with her in parallel.

Many premature births also occur due to Infections in the uterus or the vagina back to the mother. Even if an infection can have various causes, there are some things you as a pregnant woman can do to prevent it, primarily good hygiene.
If you suspect that an infection might be present (for example, because your intimate area itches or you have unusual discharge), you should see your doctor as soon as possible for treatment. Also, a robust immune system can help in defending against such infections. Balanced Nutrition and appropriate exercise are always good anyway – your midwife and your doctor will be happy to advise you on this. For recurrent infections, you should regularly treat the intimate area with lactic acid derivatives in suppository or cream form to stabilize the vaginal flora and prevent local infections.
In some cases, surgical stabilization of the cervix, known as prophylactic cerclage, may be advisable. Especially if your cervix is shortened or you have had cervical surgery, or if you suffer from cervical insufficiency or premature opening of the cervix, your doctor will consider this option. From the 16th week of pregnancy, your cervix can be surgically reinforced to prevent premature opening.

Anyway, the Information about possible risks very important for the prevention of preterm births. You should adapt your daily routine as much as possible to your pregnancy and avoid risk factors. Of course, you don't have to wrap yourself in cotton wool! Even while pregnant, you can continue to lead an active and colorful life. Talk to your trusted medical professionals about how you can manage this during pregnancy. In our magazine articles on the topics “ Pregnant – and now? ", “ Pregnancy Roadmap " and " What should be considered during pregnancy? "you will also receive helpful tips and tricks."

Myths about premature birth

During pregnancy, parents often worry a lot. When complications occur, these often turn into concerns or even self-blame. But we can reassure you: for many of the myths surrounding the topic of preterm birth, there are absolutely no scientific evidence. Some of them are listed here for you.

• Swimming: Swimming is generally very healthy for pregnant women. It is a joint-friendly way to stay active. The risk of infection is also not increased. If your doctor has no objections, there is nothing against swimming a few laps in the pool.

• Worries, arguments, and negative thoughts: Of course, it's good if you stay as relaxed as possible during pregnancy. But let's be honest – it doesn't always work that way. The hormones often do their part. And as long as you're not under constant stress, your baby can handle it wonderfully. However, if you really feel that you're mentally doing unusually poorly, talk to your doctor. It happens, and there's no reason to feel bad or even ashamed!

• Air Travel : Basically, you can fly without any problems during pregnancy. The changed pressure in the airplane and the metal detectors at the airport do not pose a danger to your baby. You are on the safe side if you discuss your travel plans with your gynecologist – in special cases, flying during pregnancy is actually advised against.

• Sex during pregnancy: In a complication-free pregnancy, you are allowed to do what you enjoy. Your baby is well protected in the amniotic sac. If you have experienced a miscarriage or other pregnancy complications, you should also consult your doctor here. Condoms are not necessary for prophylactic infection protection. However, if a known infection is present in one of the partners, the infection should be treated before resuming sexual activity.

• Need to eat more during pregnancy: Of course, during pregnancy, no active diet should be undertaken, but eating more to adequately nourish the baby is absolutely not necessary, and consuming significantly "more than necessary" can even pose a risk of supply issues such as diabetes or high blood pressure, and thus for a premature birth.

Postpartum and Maternity Leave

The period after a premature birth is full of challenges for your baby, you, and your partner. Your little explorer is probably lying in a warm bed, possibly connected to some devices, and is closely monitored by doctors and caregivers to observe or regulate his/her bodily functions and to treat or prevent potential complications. But even if you might feel a little helpless during this time – You can do a lot for your baby!

• Body contact:
  An important factor for your baby's development is body contact. Therefore, many hospitals place great importance on your baby spending as much time as possible with you or your partner – best skin to skin . That's called "Kangarooing" and it means hours of cuddling with your baby – sounds great, doesn't it? This way, you give your little explorer warmth and security and also become more confident in handling your baby. Additionally, it has been proven to strengthen your little explorer's vital functions and helps him get the perfect start in life.
  

• Breast milk:
  Preterm infants often cannot digest milk properly yet and are therefore initially given preterm formula made of sugar and water, sometimes via a tube if they lack the strength to suck. Once your little explorer is able to digest milk, expressed breast milk can be beneficial for them. Colostrum and milk from mothers of preterm infants contain important nutrients in particularly high concentration . It also helps to build your baby's gut flora and immune system. You will be advised on this in the hospital if necessary.
  

• Preemie clothing and diapers:
  Preterm babies are often very small. Most diapers in the smallest size are suitable for babies from 2 kilograms of weight, including the LILLYDOO diapers . For smaller babies, there are special preemie diapers available at the hospital. Clothing for premature babies is now also available in retail stores. You should opt for natural, minimally processed materials to avoid irritating your little explorer's skin. There are also very special preemie clothes online, featuring small pockets and openings for medical devices and tubes, and they can be easily opened and closed with Velcro fasteners.
  

• Help and Support:
  The medical staff at the hospital are experienced in caring for premature infants. Even on the ward, you will be prepared for the care and nursing of your baby at home. Use this time to build as much security and self-confidence as possible.
  
  Even after your hospital stay, a midwife can support you. You have a legal entitlement to this for at least twelve weeks, and if needed, even until the end of breastfeeding. With a corresponding certificate, many health insurance providers also cover a household help, and you could be entitled to an extended Mutterschutzfrist have.

Additionally, good medical care is important for premature babies, as potential long-term effects are often not immediately detectable. A good doctor will guide you and your little explorer safely and competently through childhood.

Life with preemies

The joint start into family life went differently than planned and maybe not
very easy. But you are not alone in this. ! You can (medical)
Getting support and it's completely okay to accept it and
to claim. Check with your health insurance provider which treatments and
Support services will be taken over. Almost all neonatological
Stations have a so-called “Early Help Program” in cooperation with social pediatric services
Centers. Here, prematurely born children are cared for by experts over the course of years.
Continuously supported by experts so that they can develop in the best possible way.

To love, warmth, and affection, your little explorer will not get anyway
fishing, but don't forget about yourself and your partner as well. Also
The mother's postpartum period should not be neglected. When family or friends offer support, listen to yourself.
and assume what is good for you. And if you like, talk about your experiences
with the premature birth. Whether with your midwife, friends and girlfriends,
Sharing experiences with your family or in a self-help group – can
help. We wish you good luck for the future with your little one
Discoverer!