Preterm labor birth, or those premature births occurring prior to thirty-seven (37) weeks of gestation, occurs disproportionately more often in the United States versus the rest of the globe. In practice, preterm labor births account for an estimated ten percent of all deliveries in the US, with 517,000 births recorded as premature or premature annually by the CDC. While the American healthcare system is more than adequately equipped to treat preterm neonatal patients, there are significant and medically-understood risks to any delivery prior to thirty-seven (37) weeks.
International Medical Community Standards for Categorizing Preterm Labor Births
Appropriate treatment in the event of a preterm labor birth is highly contingent about the relative developmental state of the fetus prior to delivery. IN practice, the developmental stage of an infant, especially as it relates to the viability of the infant’s lung capacity and other organ systems, is tied closely to a week-based metric.
- In general, any infant delivered prior to thirty-seven (37) weeks is assigned to the categorization of pre-term
- Infants delivered at thirty-two (32) weeks to thirty-seven (37) weeks are assigned the category of moderate to late preterm labor birth
- Infants delivered at twenty-eight (28) weeks to thirty-two (32) weeks are assigned the medical category of a very preterm delivery
- Finally, infants delivered prior to twenty-eight (28) weeks are considered to be extremely preterm
With the ideal length of a pregnancy entailing carrying the child to full term at forty (40) weeks, infants delivered via preterm labor birth with a gestational age at or prior to twenty-four (24) weeks pushing the limits of what is considered medically viable contemporarily.
Causes of Preterm Labor Birth
There are variegated causes of preterm birth with each pregnancy exhibiting case-specific factors contributing to the possibility of undergoing a premature birth. Fortunately, for mothers cognizant of the early signs of preterm labor including contractions, pelvic pressure, vaginal discharge, and vaginal bleeding, immediate medical attention may be able to delay or prevent preterm delivery in certain instances.
Ultimately, pre-existing risk factors can increase the possibility of parents enduring a preterm delivery, including the following:
- Mothers with histories of prior miscarriages or prior premature births
- Mothers presenting with cervical irregularities, or a history of uterine, genital, or sexual transmitted infections
- Mother presents with pre-existing conditions such as coagulation difficulties, gestational diabetes, excessive amniotic fluid, preeclampsia, or a placental abruption
Preterm Labor Births, Birth Defects, and the Linkages to Cerebral Palsy
In premature births, complications are manifold and completely contingent upon the relative development of a fetus in utero prior to premature delivery. Births prior to the twenty-four (24) week benchmark are noted by medical experts as being closely linked to specific sets of birth defects including predominantly disabilities relating to organ systems last to develop during the gestational period. Common birth defects associated with preterm labor birth include:
- Developmental, behavioral, and cognitive delays
- Impaired hearing and vision
- Deficient digestive systems
- Respiratory complications and threats to oxygen saturation levels, such as respiratory distress syndrome, which if allowed to stay appreciably low, will quickly result in permanent brain damage and other complications, such as cerebral palsy
- Jaundice
- Cerebral Palsy, which is a chronic, debilitating, and enormously costly motor impairment condition leading to extremely diminished quality of life for infants
Specifically, cerebral palsy is associated with a large percentage of preterm labor births, with a number of potential causes being possible, pending a specific preterm delivery and the ensuing onset of cerebral palsy in the child. In addition, aside from preterm birth alone, infections in the mother have been linked to infants developing cerebral palsy later in life, as well as preterm birth complications such as respiratory distress and underdeveloped brains, which are highly susceptible to intracranial hemorrhaging often linked to causing cerebral palsy as well.
Resources:
http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm
http://www.mayoclinic.org/diseases-conditions/premature-birth/basics/definition/con-20020050
http://www.who.int/mediacentre/factsheets/fs363/en/
http://www.cdc.gov/ncbddd/cp/index.html
