You've probably heard of the quintessential 9-month pregnancy, but in medical parlance, a pregnancy is considered "full term" anywhere between 37-41 weeks' gestational age. Babies born before 37 weeks are typically called "preterm" or "premature." Unfortunately, preterm births are at an elevated risk of health problems.
Preterm births require a higher standard of care
The good news is modern medicine has created ways of mitigating those risks, both by helping women carry children to term and by caring for preterm births when they do occur. Doctors and other medical professionals need to meet appropriate standards of care for preterm births in order to prevent serious injuries, however.
Risk factors for preterm birth
While the cause of premature birth is not always known, there are several well-known risk factors, including:
- High blood pressure
- Multiple births (twins, triplets, etc.)
- Being overweight or underweight
- Certain types of vaginal infections
- Poor nutrition
Many of these risks can be mitigated with proper prenatal care. For example, a doctor can recommend dietary changes or prescribe vitamin supplements in order to ensure that the mother has proper nutrition. Screening for and treatment of infections such as group B streptococcus (or "group B strep") can also reduce the risk of a preterm birth.
Two medical treatments have been shown to reduce the risk of preterm birth - cervical cerclage and progesterone therapy. Cervical cerclage is a surgical procedure that reinforces the cervix to prevent preterm labor. It is medically indicated when the mother's cervix is incompetent or short. Mothers at risk of preterm birth can also undergo progesterone therapy, which is typically initiated around the 16th to 20th week of pregnancy and lasts until the 36th week. In order to prevent preterm birth, doctors need to effectively diagnose the risk factors, recommend these medically indicated treatments and properly perform them.
Mitigating injury risks during labor and delivery
When a mother goes into preterm labor, perhaps the greatest risk to the child is fetal distress (oxygen deprivation). It is often difficult for premature babies to get enough oxygen because their lungs are not fully developed. As such, monitoring the baby's heart rate for signs of distress throughout the labor and delivery process is critical. If the baby's heart rate drops below 110 beats per minute, that is a red flag indicating distress - and an immediate c-section is generally needed to avoid brain damage.
Another common problem is hyperbilirubinemia (jaundice), which causes a yellowing of the skin and eyes when the body is flooded with a chemical called bilirubin. While this can happen in full-term babies as well, preterm babies are particularly susceptible because the liver and kidneys are not yet fully developed. Left untreated, hyperbilirubinemia can have toxic effects that cause severe type of brain damage, known as kernicterus. Children with kernicterus often develop cerebral palsy, epilepsy or hearing loss.
A simple blood test can diagnose hyperbilirubinemia, and effective treatments are available to prevent brain damage in this situation, but a misdiagnosis, delayed diagnosis or inadequate treatment can lead to lifelong complications.
Neonatal hypoglycemia (NH) is a condition in which the baby's blood sugar (glucose) levels fall dangerously low shortly after birth. Without enough glucose, brain cells will start to die, which can cause cerebral palsy and other serious medical conditions. Again, this condition can be easily identified using a simple blood test, and treatment is usually as straightforward as giving the baby more breast milk or formula to drink or administering a glucose solution intravenously if the baby cannot be fed by mouth.
Children harmed by medical negligence have legal rights
When a child's injury is caused by medical mistakes - whether during prenatal care, labor and delivery, or neonatal care - that child's family has legal recourse against the responsible medical provider or providers. In order to recover financial compensation through a medical malpractice claim, you need to prove that a standard of care was not met and that such negligence caused your child's injury.
When birth injuries occur after premature births, numerous standards of care come into play. The victim's attorney must investigate, reconstruct the narrative of how the injury occurred, and typically consult with a medical expert who can testify that a standard of care was not met. That's why it is important to seek legal assistance as soon as possible after a premature child is diagnosed with cerebral palsy or another birth injury.