Prematurity is a term describing births that occur before 37 weeks of gestation, and it accounts for as high as 33% of neonatal mortality in Nigeria. (Global Newborn Outlook – Nigeria, 2010) As an issue which accounts significantly to neonatal mortality and morbidity in Nigeria, prematurity is not just a health issue, but also a social problem which every member of society must contribute towards solving.
According to latest reports by experts, Nigeria has the highest rate of neonatal deaths caused by prematurity in Africa and second highest in the world.
At TBHI’s commemoration of World Prematurity Day 2013, the guest lecturer Dr. Eliizabeth Disu of the Lagos State University College of Medicine noted that neonatal mortality ratio in Nigeria is 40/1,000 live births, with complications from prematurity being one of the leading causes. Many of these deaths are preventable.
Other terms often used for prematurity are preterm and “preemie.” Many premature babies weigh less than 2.5 kg and may be referred to as low birth weight (LBW).
Premature infants born between 34 and 37 weeks of pregnancy often are called late preterm or near-term infants. Late preterm infants often are much larger than very premature infants but may only be slightly smaller than full-term infants.
Late preterm babies usually appear healthy at birth but may have more difficulties adapting than full-term babies. Because of their smaller size, they may have trouble maintaining their body temperature. They often have difficulty with breastfeeding and bottle feeding, and may need to eat more frequently. They usually require more sleep and may even sleep through a feeding, which means they miss much-needed calories.
Late preterm infants also may have breathing difficulties, although these often are identified before the infants go home from the hospital. These infants also are at higher risk for infections and jaundice, and should be watched for signs of these conditions. Late preterm infants should be seen by a care provider within the first one or two days after going home from the hospital
There are a number of factors linked to premature birth. Some directly cause early labor and birth, while others can make the mother or baby sick and require early delivery. These predisposing factors can be categorized in to the following groups:
- Preeclampsia – high blood pressure of pregnancy, also known as toxemia or gestational hypertension
- Chronic medical illness, such as heart or kidney disease
- Infection, such as group B streptococcus, urinary tract infections, vaginal infections, infections of the fetal/placental tissues
- Drug use, such as cocaine
- Abnormal structure of the uterus
- Cervical incompetence – inability of the cervix to stay closed during pregnancy
- Previous preterm birth
Factors involving Pregnancy
- Abnormal or decreased function of the placenta
- Placenta previa – low-lying position of the placenta
- Placental abruption – early detachment from the uterus
- Premature rupture of membranes, amniotic sac
- Polyhydramnios – too much amniotic fluid
Factors involving Foetus
- When fetal behavior indicates the intrauterine environment is not healthy
- Multiple gestation – twins, triplets or more