When Baby Comes Early

Having a 'preemie' today is far less of a worry than it once was; survival has improved dramatically

Premature Labor—Are You at Risk?

Each year 8 to 12 percent of pregnant women in the United States go into premature labor. The cause is usually unknown (as it was for Yvette Vanesko), but some of the risk factors are:

• a previous preterm delivery (this raises your risk by up to one-third)
• smoking
• drug/alcohol use
• age younger than 18 or older than 40
• history of sexually transmitted diseases

Uterine contractions sometimes can be stopped by drinking a lot of water and getting off your feet. When that doesn't work, doctors may give terbutaline, magnesium sulfate or other medications.

Today when a baby comes a few weeks early, the biggest problems for the parents are likely to be rushing to finish the nursery, get grandma there and find clothes to fit their tiny infant. Thanks to modern medical care, "preemies" who wouldn’t have made it 30 years ago not only survive but thrive.

"Some newborns as early as 22 weeks gestation may survive today," says Kara Coassolo, M.D., maternal/fetal medicine specialist at Lehigh Valley Hospital and Health Network. "The vast majority born between 28 and 37 weeks do. These later preemies have only a slightly higher chance of serious health problems than full-term (40-week) infants."

Yvette Vanesko didn’t know that when 33 weeks into her pregnancy, she began leaking amniotic fluid and her doctor sent her from her Pocono area home to Lehigh Valley Hospital. "I didn't know what it meant to be leaking fluid," she says. "I was afraid, not knowing what the outcome would be. But the nurses and doctors answered all my questions and reassured me everything would be OK."

Seven days later, little Stephen Vanesko came into the world. He was just over five weeks early and weighed a mere 5 1/2 pounds, but had no significant health problems. "He was a little jaundiced, which improved after a day or two," Vanesko says. "But his lungs were developed, he had no trouble breathing, and he went to the regular nursery. He was fantastic."

Respiratory distress is a big concern with premature infants because they don't always produce enough lung surfactant—a substance that keeps their lungs from collapsing when they breathe—until 34 weeks or beyond. If it looks as if a woman is going to deliver early, doctors can give her steroid shots that help the baby's lungs mature faster. If they're still not fully matured at birth, the lungs are treated with replacement surfactant to allow them to function properly.

It's thanks to surfactants, Coassolo says, that so many more preemies survive today. "Since the advent of this therapy, the survival rate has increased remarkably. In specialty hospitals like Lehigh Valley Hospital, the rate is up to 50 percent in infants born as early as 24 weeks," she says. "Very early babies do have a significant risk for problems with brain development compared to those born at 28 weeks or later."

The Vaneskos were fortunate to have their nursery set up and everything ready to go before Stephen was born. They had to make a last-minute search for extra-small baby clothes. But the toughest part of having a preemie for them was worrying about his future development and coping with his feeding schedule.

"Stephen ate every two-and-a-half to three hours around the clock for almost two months," Vanesko says. "By his 4-month checkup, he weighed 14 1/2 pounds and our doctor was very pleased with his development. He said only a pediatrician would know he was born five weeks early."

This page last updated 4/27/10 03:38 PM