By Victor Ogunyinka
Yes, all babies are born equal but some babies are borne out of some
unpleasant conditions that one wonders if all babies are really born
equal.
Premature birth is an unfortunate incident that sums up nonchalant attitude of a pregnant woman before and during pregnancy.
The appropriate time that a baby is termed to be delivered is between 37 to 40 weeks, according to experts.
Dr Moses Rotimi, a fellow of the West African College of Surgeon, a
consultant of Obstetrics and gynaecology and the Medical Director of
Delight Hospital and Fertility Centre, Challenge, Ibadan, defined
premature or preterm birth as delivery of the baby before 37 completed
weeks of gestation, which is approximately about 259 days of
conception.
“The appropriate time that a baby is termed to be delivered is between
37 and 40 weeks. If a baby is delivered before then, we call it a
preterm delivery and we try as much as possible to prevent this because
of the complications associated with it.
“A baby could also be delivered after 40 weeks of gestation; we call
those ones post term. 40 weeks is the expected date of delivery, but a
term pregnancy is actually between 37 and 42 weeks because those two
weeks extra is still acceptable giving the time the implantation
actually took place. On no condition should a baby stay beyond four
weeks in the mother because when complication begins to set in, the
placenta wouldn’t be able to feed the baby again,” he said.
In a preterm birth, there are some organs that are badly affected in the
baby, chief of which are the liver and lungs. The efficiency of these
organs in the body is capable of defining the life of the baby.
Experts have noted that if a baby is delivered before 37 completed
weeks, the lungs, liver and sucking reflexes of the baby may be impaired
due to their immaturity.
In the same vein, if the liver is not mature, the baby may end up with
jaundice because the liver is responsible for metabolism and
detoxification of waste products in the body. Sepsis could also come up
and eventually, the baby may die. That is not to say only preterm babies
are predisposed to jaundice. Term babies could also have jaundice
depending on what they are exposed to.
Dr Rotimi highlighted the incidence, problems, complications and
prevention of the unsuspecting incident that statistics have plagued at
20 per cent of survival rate.
Causes/incidence
Dr Rotimi revealed that the incidence of preterm birth is based on the
environment, stating that the risk factor in a rural community is bound
to be different from what obtained in urban area.
He highlighted some of the causes to include poor socio-economic status
of which he hinted that women who are unkempt and malnourished have
miscarriage more than others.
“We’ve a condition of intrauterine infection like chorioamnionitis,
which can also lead to preterm birth that is an infection of the
membrane covering the fetus, it results from the infection of the
genital tract. A woman can have vaginal discharge, malodorous vaginal
discharge before pregnancy. If those things are not treated they can
migrate upward and affect the membrane that actually covers the baby,
they can lead to infection, or we have a male partner that is having
multiple sexual partners that are having infection and still mating with
the pregnant woman now causing inflammation and then leading to
infection.
“Another cause, which is the commonest, is called preterm premature
rupture of membrane; it is defined as the rupture of membrane before 37
weeks of gestation that means that the water surrounding the baby is
already leaking because of that rupture and when that happens, there is
increased incidence of infection. When this occurs, the best thing to do
is to abort that pregnancy.”
Abdominal trauma and multiple pregnancies are other factors bound to cause preterm birth.
Complications
“When a baby is born prematurely, the chances of survival are placed at
50-50, if the delivery is before 30 weeks, it is almost certain that 80
per cent are going to die. In Nigeria, the average survival rates us
from 28 weeks upwards. The risk is so high because the lung is not
mature and we don’t have too much supportive measure for lungs maturity.
The baby has a problem with sucking, which eventually makes him
malnourished. Hypopnoea could also be an issue. Some of the
complications developed include: neurological problem, which could lead
to mental retardation and speech disorder, the baby could look so small
and the issue of self esteem could arise, though they tend to gain
weight overtime, the cost of bringing up such baby up is also more,” he
said.
Prevention
The main problems attached to premature birth are ignorance, poverty and the disease itself.
While educating the public would go a long way to reduce ignorance, Dr
Rotimi explained that improving the socio-economic status would go a
long way in reducing poverty rate. He added in general, “a woman should
have a very good personal hygiene; this could prevent infections like
chorioamnionitis. A pregnant woman should also not engage in strenuous
physical activities as that can provoke labour and lead to preterm
delivery. The issue of domestic violence is something that also has to
be taken care of. When there is a sign of infection, it should be
treated as soon as possible and pregnant women need to register for
antenatal care in a good centre,” he advised.
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