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Premature birth may affect baby's development, according to experts

Dubai - Newborn mortality has been recognised as a global health priority as rates have fallen more slowly than rates of overall child mortality.

When Chetan Ravasia and his wife came to know that their family will be complete soon, they were over the moon.
Their happiness, however, soon turned into worry and concern when the about to be mother was rushed to hospital with premature labour pains at only 25 weeks of pregnancy. 
"It was a difficult time for us since we were not expecting this," Chetan told Khaleej Times.
The couple rushed from one hospital to another in the middle of the night with an open cervix which meant birth could happen anytime. However, hospitals in Dubai refused to take the case due to lack of beds in the Neonatal Intensive Care Unit (NICU).
"We then were referred to University Hospital in Sharjah (UHS) where doctors immediately admitted my wife since it was a critical case," said Chetan.
Medication and timely treatment delayed the birth of the couple's double joy to 27 and half weeks which doctors said would mean a greater chance for the babies to survive.
Baby girl Meera and baby boy Maahir were born to the couple on November 11, weighing 970 and 930 grammes, respectively. "Today my wife has been discharged from hospital and both the babies are doing well. In fact, my daughter is stronger and she is doing better," said the proud father. Though the couple has temporarily shifted from Dubai to Sharjah until the babies are discharged from the hospital after the completion of 36 weeks (by mid-December), they are in the best of the spirits. 
Hakam Yaseen, medical director, consultant of neonatology and paediatrics at UHS who looked into Chetan's case, said that it is crucial that couples are aware of the common causes of premature delivery, such as diabetes, high blood pressure, obesity and stress. "Smoking is also a major risk factor and doctors warn against smoking of shisha before and during pregnancy," he said.
According to Hakam, around 10 per cent of all deliveries in the UAE are premature. "A baby born less than 37 weeks of gestation risks suffering from complications after birth and could face a lifetime of disability," he explained.
Newborn mortality has been recognised as a global health priority as rates have fallen more slowly than rates of overall child mortality.
According to the World Health Organisation (WHO), newborn deaths form an increasingly large percentage of overall child deaths - even as both figures continue to fall. With prematurity accounting for 35 per cent of newborn deaths globally, preventing deaths from prematurity is more of an imperative than ever before. Interestingly, the mortality of newborns at UHS accounts for less than four per 1,000 life birth.
Dr Wendy Noble, obstetrician and gynaecologist at American Hospital in Dubai, explained what happens to the woman and baby when a birth is premature.
"A normal pregnancy is 40 weeks from the date of the last menstrual period. We used to think that pregnancy was ready for a delivery i.e. term from 37 to 42 weeks but this has after much research been narrowed to 39 to 41 completed weeks," said Dr Wendy.
She said that a baby is preterm when born before 39 weeks of pregnancy have been completed - i.e. seven or more days early. "The negative effects of an early delivery for the baby increase with every additional week that the pregnancy is shortened," she said. 
Dr Wendy said that doctors used to think that if the baby was more than 37 weeks grown, there wasn't much harm if the baby was delivered at this time. "However, from all the research it is very clear that early birth carries risks for the baby not only at the time of delivery but even into childhood as preterm birth is associated with learning difficulties, and later as adults with diabetes, high blood pressure and heart disease," she added. 
However, babies need all of these 40 weeks to grow and develop normally. "The last 35 to 39 weeks is when the brain grows by 30 per cent," she explained. "This last brain development is vital for feeding, breathing and temperature control. Early babies have not yet got this ability and have difficulty in all these areas, which makes them four times more likely to need ventilation on the neonatal unit."
She said that there are some conditions for the mother or the baby that give doctors no choice but to deliver early. "These are high-risk pregnancies and when the risks are balanced, the decision is made that the risks of prematurity are lower than if the pregnancy to continue. This can be either for the sake of the baby/babies, or the mother," she added. 
"Once a mother has one caesarean section, it is much more likely that she will need another in the future. This can reduce the number of babies that she can safely have. Also, caesarean section is a major surgery and there can be problems associated with the anaesthetic, haemorrhage, infection, future problems with the scar and many other complications," she explained. 
Giving advice to women who are at risk of preterm birth, Dr Wendy said: "Ask yourself: Have you had a previous unplanned preterm birth? Have you had previous uterine or cervical surgery? Are you pregnant with more than one baby? Have you any serious medical conditions?" 
"If this is the case, you may be at a higher risk of early birth and should discuss with your doctor to put in place preventative measures to try and prolong your pregnancy," she added.
asmaalizain@khaleejtimes.com