Premature birth and preterm birth?

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Philippe Gloaguen
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Premature birth and preterm birth

We health professionals and professionals very often take it for granted that the crystalline meaning of words for us is understood by everyone but this is not always the case. And I think this is just one of these cases, the use of the word preterm or premature in relation to the time of delivery. Many times it is used as a synonym to define the birth that occurs before the 37th week, or 3 weeks after the term of pregnancy.






Preterm birth definition

The World Health Organization in an article published in November 2022, however, he specified when and how to use these terms, also highlighting the different problems that children can have. Babies born before 28 weeks are defined extremely preterm, between 28 and 32 weeks are defined very preterm and between 32 and 37 preterm weeks.

Read also: Premature birth, how to avoid it and prevent the risks

For the first two categories, the term premature can also be used in the sense of: "not yet fully matured from a physical point of view". If we rely on the data collected in all countries about one in 10 children is born before term and it seems that this number is destined to grow.



Premature baby: why does it happen?

There are various reasons such as twin pregnancy, infections, gestational diabetes, hypertension, genetic factors, but a single trigger has not yet been identified.



Babies born before the 28th week of pregnancy

However, not all babies who are born preterm need hospitalization in intensive care, the closer you get to the term of your pregnancy, the more your baby will be able to survive without complications or without the need for support. Going into the details of the physical maturation of the child we can say that: children born before the 28th week they have great difficulty in being able to survive without any support, in fact they have no autonomy of functioning of the organs except the heart and the brain is still in formation. Furthermore, the absence of subcutaneous fat makes them very sensitive to temperature changes.

Babies born between 28 and 32 weeks of pregnancy

Between 28 and 32 weeks instead the subcutaneous fat begins to form, the organs create their connections with the brain and may already be able to function independently, with the exception of the lungs which are the last organ to fully develop. They will therefore require lung maturation techniques and in some cases even respiratory assistance. Physically they are small and thin.

Babies born from 32 weeks of pregnancy

Starting at 32 weeks everything is improving the organs and the brain come into full function, physically they are less wrinkled and more plump and, starting from 35-36 weeks, the lungs will also be mature so they will not need any support.

I would like to point out that these differences in functionality and development are worked out by the experts on the basis of statistics from different countries and different cases. The variability between baby and toddler can also be high and a lot depends on the cause of the preterm birth. Clearly, childbirth assistance protocols and procedures are subject to constant review, not only by individual hospitals but also at central level, the World Health Organization, for example, publishes a review of the previous guidelines every 3-5 years. with updated data.

WHO guidelines

The purpose of the guidelines is twofold, on the one hand the prevention of childbirth and on the other the well-being of the newborn. In the first case, the various procedures that can be performed include cervical cerclage (essentially the cervix is ​​kept closed with a semi-invasive procedure to prevent it from dilating and starting preterm labor) and the administration of some drugs including magnesium sulfate to prevent contractions. On the other hand, with regard to the well-being of the child, the new guidelines have placed a strong emphasis on the need for the possibility to be given in any case skin / skin contact with parents and siblings. It has in fact been seen that even highly premature babies are able to better stabilize vital functions and body temperature if put in contact with family members rather than left alone in the incubator. However, since these indications are so recent, not all hospitals are yet equipped, but I think we will get there very soon.

Conclusions

I hope with these few words I have made a little bit of clarity for you mothers, fathers and families who are often confused in front of a little smoky medical terminology. I would like to repeat that each case is then independent and therefore the evaluation of conditions of the preterm infant it is up to the professionals who assist them in the moment of birth, they are not the same for everyone and this is, in a certain sense, a guarantee that individual children receive the most suitable assistance for them.

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