Complications


A premature baby is one who is born before 37 weeks of pregnancy. A number of problems are associated with prematurity. These include:

Jaundice
Bilirubin is produced when ageing, damaged, or abnormal red blood cells are removed from the circulation, and are broken down by the liver. Hyperbilirubinemia , a high level of bilirubin in the blood, and Jaundice, the yellow skin colour due to high bilirubin blood levels, is common in premature infants , who do not have fully developed organs and, thus, their livers cannot process bilirubin rapidly. Hyperbilirubinemia may be due to an overproduction and/or underexcretion of bilirubin. Extremely high levels can be harmful & usually involves phototherapy (therapy with bilirubin lights).

Apnea of Prematurity
Apnea is a medical term that means a baby has stopped breathing. Most experts define apnea of prematurity as a condition in which premature infants stop breathing for 15 to 20 seconds during sleep. Generally, babies who are born at less than 35 weeks’ gestation have periods when they stop breathing or their heart rates drop. (The medical name for a slowed heart rate is bradycardia). These breathing abnormalities may begin after 2 days of life and last for up to 2 to 3 months after these premature infants are born. The lower the infant’s weight and level of prematurity at birth, the more likely it is that the infant will have AOP spells.

Anaemia
Anaemia is where there are too few red blood cells, which carry oxygen around the body. This condition in neonates may be due to various factors. Anaemia does not always need to be treated if it is not severe and if the baby is not sick or having frequent laboratory tests (e.g. where blood is taken from the baby). Eventually the baby will make more red blood cells of his/her own accord. If treatment is necessary, it usually involves blood transfusions

Bronchopulmonary dysplasia (BPD) / Chronic Lung Disease (CLD)
BPD or CLD is a lung disease that commonly occurs in infants who are on a breathing machine for some period of time. It involves damage to the lungs that is usually temporary and will heal with time. Infants with BPD or CLD require oxygen therapy and/or ventilator support until their lungs have healed. Medications such as steroids and diuretics may be required to help improve lung function. Special attention is given to nutrition to help repair lung tissue and promote growth.

Patent Ductus Arteriosus
The ductus arteriosus is the blood vessel, which connects the pulmonary artery (main vessel leading to the lungs) to the aorta (main vessel of the body). In the uterus foetal blood does not need to go to the lungs as oxygen is provided by the mother, through the placenta . However, following birth it is the infants’ lungs which must now provide oxygen. Normally in the hours following birth, the ductus arteriosus seals as it is no longer needed. Treatment, if deemed necessary for a premature baby, an aspirin-type drug called indomethacin is often given. Indomethacin has been shown to be very effective in causing the PDA to close. Patent Ductus Arteriosus (PDA) results in a build-up of blood and fluid in the lungs which may cause difficulties in breathing for the infant, an increase in heart-rate and may produce heart failure. If a PDA does not respond to medication, or is due to causes other than prematurity, surgery may be needed. This surgery is called ligation and involves placing a suture around the ductus to close it.

Retinopathy of Prematurity
Retinopathy of Prematurity (ROP) is abnormal growth of blood vessels in a baby’s eye, which is most common in babies who are very premature, more than 12 weeks early. As the development of blood vessels in the eye is a process that is finished only shortly before birth, the process may not continue normally in very premature infants. If your child has been diagnosed he/she may require laser of the eye(s).

NEC
NEC is an inflammation causing destruction or even death ( necrosis ) of part of the bowel. This may occur in premature infants who have immature and fragile bowels and are sensitive to changes in blood flow as well as to infection. Symptoms of this uncommon disorder include blood in the stool, swollen stomach and vomiting bile-coloured (i.e. green) stomach contents. Due to the severity of this condition, doctors may start treatment simply on the suspicion that an infant may be developing symptoms of NEC.

Intraventricular Hemorrhage (IVH)
Infants with IVH have a bleed within the brain that can range from mild to severe in nature. A premature baby’s blood vessels in their brain are very fragile and may rupture easily. For those infants at greatest risk for IVH, head ultrasounds will be performed to detect and/or follow up infants with IVH.

Hernia
Hernias are a weakness in the muscle wall of the abdomen. Many premature babies develop hernias in their belly buttons called an umbilical hernia. Umbilical hernias do not require treatment, but some babies need surgery to repair the hernia. Some premature babies develop a hernia in one or both groins called inguinal hernia. Inguinal hernias require surgery to repair. Most babies tolerate surgery very well. The hernia becomes noticeable when the infant is a couple of months old.

Weight gain/loss
It is normal for babies to lose weight the first week of life, then start to gain. The smaller the baby, the longer it may take to get back to get back to birth weight. Measuring your baby’s weight every day to every 2 days will enable the doctors to adjust the treatment plan based on your baby’s needs.

The subject matter provided in these articles is strictly for informational purposes alone and should never be used in the place of a doctor’s advice. Please ALWAYS contact your doctor if you ever have questions or need advice in any area where medical advice is needed or medication is suggested.