Premature Births and Birth Injuries
Medically speaking, babies are "at term" between 37-41 weeks' gestational age. Births that occur before 37 weeks are "preterm" or "premature."
Historically, premature babies were at severe risk of serious illness or death. Modern medicine has made great strides both in preventing preterm births and in caring for babies who are born prematurely. Many premature babies grow up to be healthy adults, but preterm birth is still correlated with some significant health complications, including birth injury.
Risk factors and prevention of preterm birth
Every pregnancy is different, and the causes of preterm labor are not always well understood. There are several well-known maternal risk factors for preterm labor, including:
- Mother's age (under 16 or over 35)
- Certain infections such as bacterial vaginosis
- Previous preterm births
- Previous miscarriages
- Multiple births (twins, triplets, etc.)
- Tobacco, alcohol or substance use
- Insufficient cervix
- Short time between pregnancies (less than six months)
- High blood pressure
- Being overweight or underweight
- Physical injury or trauma
While some of these risk factors cannot be controlled once pregnancy begins, doctors have a responsibility to advise mothers of risk factors that could cause preterm labor. For example, a doctor can advise a patient to stop smoking or take steps to lower blood pressure in order to reduce the risk to the baby. In addition, there are some interventions doctors can perform to help prevent preterm labor. Such interventions include prescribing progesterone supplements and performing cervical cerclage, a surgical procedure that strengthens the cervix to help the mother's body carry the baby to term.
Birth injury risk factors for premature babies
Even with proper medical attention during pregnancy, some babies may still be born prematurely. During labor and delivery, as well as neonatal care, doctors need to be aware of certain risk factors, including:
Hypoxia (oxygen deprivation): Premature babies are particularly likely to experience oxygen deprivation because their lungs are not fully developed. Doctors need to monitor the baby's heart rate for warning signs of hypoxic ischemic encephalopathy (HIE), a serious complication that causes brain damage.
Jaundice (yellow skin or eyes): Jaundice is caused by a buildup of a chemical called bilirubin in the bloodstream. Most babies develop some amount of jaundice, but premature babies are at increased risk of developing dangerous levels of bilirubin because the liver, which naturally removes bilirubin from the blood, is not fully developed. Untreated jaundice can cause hyperbilirubinemia and kernicterus, a type of brain damage.
Infections and sepsis: Preterm deliveries are often caused by infections in the mother's body, and if that infection spreads to the baby, serious complications can follow, especially if the baby's immune system is not fully developed. One severe complication of infection is meningitis, an inflammation of the membranes surrounding the brain and spinal cord that can cause permanent damage.
Birth trauma: Premature babies' bodies are particularly small and fragile. Doctors need to be especially careful during labor and delivery to avoid traumatic injuries.
These complications are well known and largely treatable and preventable. Although doctors are certainly not expected to be perfect, they are expected to follow standards of care, and that includes keeping a particularly close eye on premature babies. If your child was born prematurely and sustained a long-term injury, a free consultation with an attorney in your jurisdiction can help you understand your family's legal options.