Complications in Premature birth

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 A typical pregnancy lasts about 40 weeks, yet there are some cases of premature birth. A premature birth is a birth that takes place before the 37th week of pregnancy.

With the help of modern medicine and new advancements in technology, babies are often able to survive when born earlier during the pregnancy. These advancements include:

  • nutrition management
  • family integrated care programs
  • skin-to-skin contact with premature babies
  • efforts to reduce the number of infections in premature babies

While situations have improved for premature babies, complications still occur. The following complications can affect preterm babies in the first weeks after birth.


Jaundice is one of the common type of complications that occur to premature babies; it can be exaggerated, physiologic jaundice. As a result, bilirubin (substance which is produced during the normal breakdown of red blood cells) accumulates in the baby’s blood and spreads into the tissue. As bilirubin is a yellowish color substance, the baby’s skin takes on a yellowish tint. However, if the bilirubin level gets too high (above 15-20 mg/dL), it can cause bilirubin toxicity. The substance can then build up in the brain and cause brain damage.


The standard treatment for jaundice is phototherapy which involves placing a baby under bright lights. The lights help break down the bilirubin into a substance that the body can get rid of more easily. Usually phototherapy is used for less than a week and after that, the liver is mature enough to get rid of bilirubin on its own.

Kidney problems

Problems regarding the balance of the body’s fluids, salts, and wastes can occur during the first four to five days of a premature baby’s life, especially for babies less than 28 weeks. During this time, a baby’s kidneys may face difficulty in,

  • filtering wastes from the blood
  • getting rid of wastes without excreting excess fluids
  • producing urine

When kidney problems are encountered, neonatal intensive care unit (NICU) staff carefully record the amount of urine a baby produces and may also test the blood for levels of potassium, urea, and creatinine. If problems arise with kidney function, need to restrict the baby’s fluid intake is needed or give more fluids so that substances in the blood are not overly concentrated.


The most common basic treatments for kidney problems include fluid restriction and salt restriction. Immature kidneys usually improve and have normal function within a few days.


A premature baby can develop infections in almost any part of the body ranging from in utero (while in the uterus), birthing through the genital tract, to after birth including the days or weeks in the NICU. Infections in premature infants are more difficult to treat for two reasons:

  • A premature baby has a less developed immune system and fewer antibodies from the mother than a full-term baby.
  • A premature baby often requires a number of medical procedures, including insertion of intravenous (IV) lines, catheters, and endotracheal tubes and possibly assistance from a ventilator.

If your baby has an infection, following symptoms may occur:

  • lack of alertness or activity
  • difficulty tolerating feedings
  • poor muscle tone
  • unable to maintain body temperature
  • pale or spotted skin color, or a yellowish tint to the skin (jaundice)
  • slow heart rate
  • apnea (periods when the baby stops breathing)

These signs may be mild or strong, depending on the severity of the infection.


If there is a evidence of infection, your baby may be treated with antibiotics, IV fluids, oxygen, or mechanical ventilation. Although some infections can be serious, most babies respond well to treatments, including antibiotics if the infection is bacterial. The earlier the baby is treated, the better the chances of successfully fighting the infection.

Breathing problems

Breathing problems are caused by an immature respiratory system. Immature lungs in premature babies often lack surfactant which is a substance that coats the inside of the lungs and helps keep them open. Without surfactant, a premature baby’s lungs can’t expand and contract normally which increases their risk for respiratory distress syndrome.

Some premature babies can also develop apnea and experience pauses in their breathing which lasts for at least 20 seconds.

Some premature babies who lack surfactant may need to be put on a ventilator but putting in a ventilator for a long time can increase risk of developing a chronic lung condition called bronchopulmonary dysplasia. It causes fluid to build up in the lungs and increases the likelihood of lung damage.


Being on a ventilator for an extended period of time may injure a baby’s lungs, and therefore it is necessary for the baby to receive continued oxygen therapy and ventilator support.

Heart problems

The common heart condition affecting premature babies is called a patent ductus arteriosus (PDA). The ductus arteriosus is simply a opening between two major blood vessels of the heart. In premature babies, it may remain open instead of closing as it should soon after birth. If this occurs, it causes extra blood to be pumped through the lungs in the first days of life.


Babies can be treated with the indomethacin, which causes the ductus arteriosus to close. If the condition still remains open and symptomatic, an operation to close the duct may be required.

Brain problems

Brain problems can also occur in premature babies which includes intra-ventricular hemorrhage, which is bleeding in the brain. Mild bleeding doesn’t always cause permanent brain injury. However, heavy bleeding can cause permanent brain injury and cause fluid to accumulate in the brain can affect a baby’s cognitive and motor function.


Treatment for brain problems can range from medication, therapy to surgery, depending on the severity of the problem.

Long-term complications

Premature birth complications can be either short-term or long-term. Long-term complications include the following:

Cerebral palsy

A movement disorder that affects muscle tone, muscle coordination, movement, and balance is termed as cerebral palsy which is caused by an infection, poor blood flow, or a brain injury during pregnancy or after birth.


Nothing can permanently cure cerebral palsy, but treatments can help improve any limitations. Treatments include:

  • assistive aids like hearing aids, eyeglasses, and walking aids.
  • medications to help with prevent muscle spasms, like diazepam and dantrolene
  • surgery to improve mobility.

Vision problems

Premature babies are affected by vision problems like retinopathy of prematurity. Here blood vessels in the back of the eye become swollen and can cause gradual retina scarring and retinal detachment, which increases the risks of vision loss or blindness.


In cases of severe retinopathy, some of the following treatments may be used:

  • cryosurgery, involving freezing and destroying abnormal blood vessels in the retina
  • laser therapy, uses powerful light beams to burn and eliminate abnormal vessels
  • vitrectomy, a surgery to remove scar tissue from the eye
  • scleral buckling surgery, placing a flexible band around the eye to prevent retinal detachment

Hearing problems

Some premature babies experience some hearing loss. It can even cause deafness.  Some of the signs that baby having hearing loss are:

  • not being startled by loud sounds
  • not imitating sounds
  • not babbling by one year of age
  • not turning at the sound of your voice


Depending on the cause of hearing loss in your baby, treatments vary which includes,

  • surgery
  • ear tubes
  • hearing aid
  • cochlear implant

Dental problems

Dental issues including tooth discoloration, delayed tooth growth, or improper alignment can affect a premature baby later in life.


A pediatric dentist can help correct these problems.

Behavioral problems

Prematurely born children are more likely to have behavioral or psychological problems. These include attention-deficit disorder (ADD) and attention-deficit/hyperactivity disorder (ADHD).


Creating structured and consistent scheduled medication including Ritalin or Adderall, can help kids with ADHD.

Impaired cognitive function

Premature babies are also at greater risk for long-term disabilities, which can be intellectual, developmental, or both. These children may develop at a slower rate than babies born full-term.

Chronic health problems

Premature babies also have a greater risk of chronic health problems which can be more susceptible to infections, and may suffer from other problems such as asthma or difficulty feeding. Also include an increased risk of sudden infant death syndrome (SIDS) among premature infants.