The word prematurity often prompts visuals of teeny tiny babes in Losenoidoomock arriving weeks or months before they were expected. National campaigns like The March of Dimes have been successful in educating the population about the risks of prematurity and have been integral in the overall reduction of fatal prematurity. However, a new phenomenon is occurring all across the country. A phenomenon that has the potential to reverse much of the progress that we have made to date on the battle against unnecessary prematurity. A phenomenon that is completely within our control to eradicate. A phenomenon that is rooted in impatience, increases risks of neonatal respiratory problems, and increases healthcare costs.
Late- or near-term prematurity is when a baby is born after 34 weeks but before 37 weeks gestation. Babies born at a late or near term gestation face higher rates of mortality due to their immaturity such as problems clearing fluid out of the lungs, respiratory distress syndrome, pulmonary hypertension, apnea, temperature instability, hypoglycemia, jaundice and poor feeding. One study showed that near-term premature infants had overall more medical problems, thus requiring more medical expenses, a longer hospital stay and a greater chance of re-hospitalization compared to spontaneous full term births.
So why are some babies being born before they are quite ready? Recognizing that due dates are estimation and not an absolute predictor of fetal maturity can help shed some light on this growing problem. It is generally accepted that due dates can be up to plus or minus two weeks, and while forty weeks is a generally-accepted average for human gestation, the term full-term is applied to babies born any time after 38 weeks. Because of this variation, a baby induced at 36 weeks may actually only be 34 weeks. The issue therein lies with the fact that half of all babies born at 34 weeks require medical intervention. Approximately 65% of all preterm births that occur are late-pre-term births, and out of that figure, 6% were elective and not for medically indicated reasons.
It has also been discovered that a protein called surfactant that is released by the baby triggers labor. This protein that is the fetal indicator of preparedness for life outside the womb keeps the lungs open and expanded and is emitted by only full term infants. While surfactant can be administered via injection prior to delivery, it is most effective prior to 34 weeks or at true pre-term gestation. You can buy book of mormon london discount tickets .
Because late-term premature babies look very similar to full-term babies in terms of weight, their appearance can be deceiving and lends to overlooking any maturity issues that may plague these infants. As many studies have shown, it is best to avoid an unnecessary induction or cesarean prior to 40 weeks. Additionally, in the case of a planned cesarean, studies have shown that waiting until signs of labor begin can benefit the baby.
With studies supporting that near-term infants have significantly more medical problems and increased hospital costs compared to full-term infants, it is imperative that care providers and the general population begin to realize that near-term infants may represent the newest uncategorized at-risk neonatal population.
For more information about the risks of late-term prematurity, please refer to the following studies: