A good head start
ACCORDING to World Health Organization statistics, there were 12.3 preterm births per 100 live births in Malaysia in 2011. This number is still about the same today.
Preterm is when a baby is born alive before the 37 weeks of pregnancy is completed.
“Very little is known about the underlying causes of preterm births,” says Dr Loo Hui Min, resident paediatric and neonatology consultant at Mahkota Medical Centre.
Measures can be taken both preconception and periconception ( after conceiving) to reduce the risks of preterm labour.
One way to reduce the risk of preterm birth preconception is planning your pregnancies to ensure they are adequately spaced out; ideally, pregnancies should be 18 to 24 months apart.
Other risk- reducing measures include ensuring the mother’s pregnancy weight is optimised – avoid a body mass index lower than 18.5kg/ m or more than 25kg/ m and maintain a healthy and nutritious diet supplemented with folic acid and appropriate vitamins.
All this can improve the overall health of the mother and baby.
Preconception medical check- ups for medical conditions such as diabetes or hypertension and sexually transmitted diseases should also be carried out so that treatment and management can commence immediately.
Periconception care includes check- ups to screen for conditions such as gestational diabetes and hypertension, and maintaining a healthy diet with folic acid and iron supplementation.
“Women with a previous history of preterm birth should get themselves screened to ensure their cervix is not structurally weak,” advises Dr Loo, explaining that the weight of the baby may cause a structurally weak cervix to open before the baby is ready to be born.
In this case, your doctor may suggest a placement of circumferential stitches to strengthen the cervix.
Multiple gestation pregnancies ( more than one baby at a time) should also be closely monitored, as these types of births are often preterm due to there basically not being enough space in the uterus for all the babies to grow to full term.
Women who have early signs of labour should immediately seek medical attention. “It is possible for the obstetrician to prolong the pregnancy and slow down labour with medications,” explains Dr Loo.
Babies born premature are at risk from myriad complications that mainly arise due to incomplete development.
For example, immature lungs may lead to difficulties in breathing, an immature liver may lead to the baby being jaundiced or an immature immune system may leave the baby highly susceptible to infection.
Mothers are often given antenatal corticosteroids at least 24 hours before giving birth to reduce morbidity and mortality in the preterm baby.
These medications are known to reduce the risk of respiratory distress syndrome ( a condition caused by lung immaturity that results in the lungs collapsing) and intraventricular haemorrhage ( bleeding into the brain) in preterm babies, among others.
Dr Loo explains that one of the most common problems premature infants face is sucking, swallowing and breathing incoordination.
Preterm babies often need help to feed and are more likely to aspirate ( get food in their lungs).
These infants should also be monitored for necrotising enterocolitis, a rare condition that affects the intestinal wall of very premature babies.
“Premature babies also have very little body fat and need good thermal care and so are often placed in incubators,” says Dr Loo.
“The severity of the risks these babies face depends on how premature they are. All these babies require specialised care by trained professionals.
“Therefore, it is important to ensure you deliver your preterm baby in a centre that is able to handle the mother and baby care effectively,” says Dr Loo.
She advises prospective parents not to be discouraged by the risks of premature births.
“Good maternal healthcare from preconception to birth significantly decreases the risks of preterm labour and birth. Parents should educate themselves about these good practices and be aware of all possibilities,” she says.
“Further, modern advances in neonatal care means that the outcome for preterm babies is generally favourable.”
For more information, call 06- 285 2999.
Dr Loo Hui Min.