Facts & Figures - a quick look

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Globally preterm birth accounts for over 9.5% of all births.  This means that over 13 million babies are born too soon every year.


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90% of Preemies survive

Thirty years ago less than 25% of the tiniest preemies were surviving, now almost 90% survive.  Learning about preterm birth can help increase awareness of the unique needs of preemies and their families.

Here you can find out about General Statistics and Preemie Outcomes. Make sure to have a look...


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Preemie Outcomes by gestational age

The more preemie and the tinier a preemie baby is born, the greater the risk for a number of health complications.

It is important to be aware that not all babies born preemie will have difficulties, either severe, moderate, or mild, but it is also sensible to be aware of the risk factors so that you, as preemie parents, can do all you can to optimise development, and limit the impact of early exposure to sensory stimulation. Be prepared and armed with knowledge about preemie birth, enables you the ability to seek out help and keep abreast with intervention programs, preemie developmental optimisation, and when professional testing may be valuable.

The chance of a preemie baby surviving outside of the mother’s womb is influenced by a number of factors but mostly it depends on the degree of maturity of the babies organs because this affects;

  • Whether the preemie baby can breath
  • Whether the preemie babies skin can hold in vital fluids
  • Whether the preemie babies brain can handle medical treatment and the early sensory stimulation

Preemies 22 weeks gestational age

Very few preemie babies survive who are born this early. Research has reported rates of between 2% to 15%

The survival of preemie infants at this gestational age is largely anecdotal so specific data regarding disability and other preemie health outcomes on this group are limited.  

Preemies 23 to 25 weeks gestational age(micro preemies)

With each week of life the chances of survival increase significantly,

Preemie survival

  • Ten to fifteen years ago these (micro) preemie babies were unlikely to survive, now with the advancements made in neonatal medical care they have a much better chance of surviving.
  • With each week of life the chances of survival from preemie babies increase significantly, for preemie infants born at 23 weeks the reported rate of survival is between 15% and 40%.
  • For preemie babies born at 25 weeks the chance of survival increases to around 55% to 70%.

Preemie health outcomes

  • Due to the immaturity of preemie babies bodies and because they often must endure a lot of poking and prodding, like machines to help them breathe or tubes for feeding or antibiotics, they are at risk for a number of long-term health difficulties. It is important to remember that not all preemie babies will have long-term problems and it is not always easy to predict which babies will have continuing difficulties but the following information is based on data that has been reported by experts in the field of prematurity.
  • Of preemie babies born between 23 and 25 weeks gestational age around 30-40% will develop normally without any major health concerns or disabilities. In contrast, around 20 to 35% of preemie infants born this early will have severe disabilities such as cerebral palsy, severe intellectual impairment, blindness, deafness, or a combination of these, which will require significant medical care well beyond that usually needed to care for babies of the same age.
  • The remaining preemie infants (25 to 40%) will have mild to moderate disabilities, such as subtle forms of visual impairment, mild cerebral palsy affecting motor control, chronic asthma, learning difficulties, and behaviour problems like attention deficit disorder.
  • There are a number of risk factors aside from gestational age and birth weight that increase the risk of preemies developing ongoing health problems. These include but are not limited to, damage to the white matter of the brain, chronic lung disease, and growth restriction in their mother’s womb.

Other preemie considerations

  • Preemie infants at this age will spend most of the day trying to sleep.
  • Preemies will have a relatively large head compared with his/her tiny body
  • Downy hair on face and body – called lanugo, this is normal for this stage of a babies’ development and will disappear naturally
  • Preemies skin appears transparent (i.e. you can see the delicate pattern of blood vessels under the skin, this is because the fatty layer under the skin has not had time to build up
  • The tone of a preemies skin is often darkish red because circulation may not be very good and may not contain enough oxygen
  • Skin bruises easily and may look waxy – preemie skin is very fragile and vulnerable to handling
  • Preemie's eyes may be fused and may not have eyelashes yet
  • Preemie's ears are soft and flexible
  • For preemie girls, her clitoris will seem quite prominent, protective folds of the labia have not grown
  • For preemie boys, testes have not descended and will be tucked inside his body
  • Preemie babies will be low in energy
  • Preemie may stretch and bring hand to mouth to suck thumb or fingers, make a fist or splay them open
  • Physical sensations – Your preemie may detect simple black and white images, can hear, and feel pain.
  • Preemies can communicate using facial expressions and body language (these may differ from full term babies – see baby watching; understanding preemie body language for more information)
  • Preemies can’t feed for themselves because they can’t coordinate their sucking, swallowing, and breathing (this means they can’t breast feed or feed from a bottle without choking).
  • Your preemie may be able to recognise voices, especially mother’s voice
  • Preemies cannot lie in fetal position unless supported to do so rather lies with arms and legs sprawled out sideways. Preemie babies do not have the active muscle tone in their limbs to curl and lay in the fetal position or lift their head.
  • Preemies born this early will not be able to cry
(Anderson & Doyle, 2006; Bradford, 2003; Doyle & Anderson, 2005; Hack et al., 2005; Taylor, Espy, & Anderson, 2009)

Preemies 26 to 28 weeks gestational age

Preemie survival

  • Preemie survival rates are 75% to around 85%
  • Preemie babies born at 25 weeks: survival is between 55% and 70%.
{Wilson-Costello, 2005 #304}{Lemons, 2001 #938}{Fanaroff, 2007 #911}{Laws, 2008 #761}{Victorian Infant Collaborative Study, 1997 #811}..

Preemie health outcomes

  • Due to the immaturity of preemie babies bodies and because they often must endure a lot of poking and prodding, like machines to help them breathe or tubes for feeding or antibiotics, they are at risk for a number of long-term health difficulties. It is important to remember that not all premature babies will have long-term problems and it is not always easy to predict which babies will have continuing difficulties but the following information is based on data that has been reported by experts in the field of prematurity.
  • Although these babies are born extremely early they do have better outcomes than the micro preemie. Despite the fact that these infants are at risk for poorer health outcomes many go on to have completely “normal” development and live healthy lives.
  • Severe disabilities such as cerebral palsy, severe intellectual impairment, blindness, deafness, or a combination of these occur in around 10% to 25% of these extremely preterm babies. Difficulties of a mild nature, such as subtle forms of visual impairment, mild cerebral palsy affecting motor control, chronic asthma, learning difficulties, and behaviour problems like attention deficit disorder, occur in much higher numbers around 50-60%.
  • There are a number of risk factors aside from gestational age and birth weight that increase the risk for developing ongoing health problems. These include but are not limited to, damage to the white matter of the brain, chronic lung disease, and growth restriction in their mother’s womb.

Other preemie considerations

  • Preemie infants at this age will spend most of the day trying to sleep.
  • Preemies will have a relatively large head compared with his/her tiny body
  • Downy hair on face and body – called lanugo, this is normal for this stage of the babies’ development and will disappear naturally
  • The skin appears transparent (i.e. you can see the delicate pattern of blood vessels under the skin, this is because the fatty layer under the skin has not had time to build up
  • The tone of his/her skin is often darkish red because circulation may not be very good and may not contain enough oxygen
  • Skin bruises easily and may look waxy – it is very fragile and vulnerable to handling
  • Eyes may be fused and may not have eyelashes yet
  • Ears are soft and flexible
  • For girls, her clitoris will seem quite prominent, protective folds of the labia have not grown
  • For boys, testes have not descended and will be tucked inside his body
  • Babies will be low in energy
  • May stretch and bring hand to mouth to suck thumb or fingers, make a fist or splay them open
  • Physical sensations – may detect simple black and white images, can hear, and feel pain.
  • Preemies can communicate using facial expressions and body language (these may differ from full term babies – see baby watching; understanding preemie body language for more information)
  • Can’t feed for themselves because they can’t coordinate their sucking, swallowing, and breathing (this means they can’t breast feed or feed from a bottle without choking).
  • May be able to recognise voices, especially mother’s voice
  • Cannot lie in fetal position unless supported to do so rather lies with arms and legs sprawled out sideways. Premature babies do not have the active muscle tone in their limbs to curl and lay in the fetal position or lift their head.
  • Preemies born this early will not be able to cry
(Anderson & Doyle, 2006; Bradford, 2003; Doyle & Anderson, 2005; Hack et al., 2005; Taylor, Espy, & Anderson, 2009)

Preemies 29 to 32 weeks gestational age

Preemie Survival

  • These babies are still preemie but have an excellent chance of survival. Advancements in neonatal medical care over the past 20 years mean that the survival rate for these infants is much improved and is now between 90% and 95%.
{Meadow, 2004 #258;Wilson-Costello, 2005 #304}.

Preemie Health outcomes

  • The health outcomes for preemie babies at this age are also improved. Around 60% to 70% develop normally without any serious medically issues.
  • Approximately 10% to 15% are at risk of severe disabilities, such as cerebral palsy, severe intellectual impairment, blindness, deafness, or a combination of these, which will require significant medical care well beyond that usually needed to care for babies of the same age
  • Around 15% to 20% will have mild to moderate difficulties, such as subtle forms of visual impairment, mild cerebral palsy affecting motor control, chronic asthma, learning difficulties, and behaviour problems like attention deficit disorder occur in of these preemies.

Other preemie related considerations 

  • Preemie's head is not yet proportional with his/her body
  • Preemie's blood vessels may still show through the skin but over the next few weeks will become harder to see as he/she begins to build up a layer of fat.
  • Preemie will have soft downy hairs, called lanugo, on his/her face and body – this develops naturally in the uterus and will disappear over the next few weeks.
  • Preemie's ears are soft and flexible
  • For preemie girls, her clitoris will seem quite prominent, protective folds of the labia have not grown
  • For preemie boys, his scrotum looks smoother than older baby’s.
  • Preemie may be able to move arms, legs, and body around
  • Preemie may be able to grasp your finger firmly
  • Preemie may be able to suck on a pacifier
  • Preemie may be able to begin practising sucking on mother’s nipple
  • Preemie may be able to turn his/her head toward the sound of a voice or another sound that draws his/her attention
  • Preemie may be able to focus on a face or picture of interest at fairly close distance (25cm or 10 inches)
  • Preemie may be able to recognise their parents voices and faces
  • Preemie’s this early will still feel pain
  • Can cry
  • Preemies stay awake for short periods
  • Preemies can communicate using facial expressions and body language, may interact with you a little (these may differ from full term babies – see baby watching; understanding preemie body language for more information)
  • Preemies cannot lie in fetal position unless supported to do so rather lies with arms and legs sprawled out sideways. Preemie babies do not have the active muscle tone in their limbs to curl and lay in the fetal position or lift their head.
  • Preemie won’t be able to hold his head up if in a sitting position
  • Although can now suck it is unlikely that your preemie can breast-or bottle-feed.
  • Preemies this immature find it very difficult to coordinate sucking, swallowing, and breathing regularly and in the correct order – this is why preemie babies are fed most of their food by tube, called a nasogastric, or NG tube
  • Needs help staying warm and probably breathing
(Meadow, Lee, Lin, & Lantos, 2004; Wilson-Costello, et al., 2005)(Doyle & Anderson, 2005; Hack, et al., 2005; Wilson-Costello et al., 2007)

Preemies 33 to 36 weeks gestational age

Preemie Survival

  • These preemies survival rate is greater than 95%

Preemie Health outcomes

  • Although the health outcomes for older more mature preemie infants are favourable compared with those born earlier they are still at greater risk for some difficulties. The likelihood of severe disability is approximately the same as infants born at term however these preemie babies are at greater risk for mild cerebral palsy, developmental delay and school-related problems.

Other preemie considerations

  • May still have some of the soft downy hair, called lanugo, on his/her face and body this develops naturally in the uterus and will disappear over the next few weeks
  • Likely to be thinner and lighter than a baby born at term
  • For girls, her outer labia may not yet completely cover her inner labia, vaginal opening and clitoris
  • For boys, both his testes may not have dropped into place. Sometimes only one and sometimes one or both testes move back into the body again – this is called retractable testes
  • At around 37 weeks, his/her hands may be strong enough to hold tight to your fingers as you carefully pull him/her up
  • May try to hold his/her head steady, in the sitting position may try to bring his/her head up off his chest and hold it there for several seconds
  • May be able to move arms and legs fairly strongly and smoothly
  • May be able to bring hands up to his/her mouth to suck fingers
  • May be able to see as well as a baby born at term, and may show interest in faces and patterns
  • May try to follow your face with his/her eyes or voice
  • Will probably recognise parent’s voices
  • May coo or try to
  • May need help with feeding and breathing
  • May need help keeping warm
  • (Morse, Zheng, Tang, & Roth, 2009; Petrini et al., 2009)

     


    Technical Reference List

    Anderson, P. J., & Doyle, L. W. (2006). Neurodevelopmental outcome of bronchopulmonary dysplasia. Seminars in Perinatology, 30(4), 227-232. Bradford, N. (2003). Your premature baby the first five years. Toronto: Firefly Books. Doyle, L. W., & Anderson, P. J. (2005). Improved neurosensory outcome at 8 years of age of extremely low birthweight children born in Victoria over three distinct eras. Arch Dis Child Fetal Neonatal Ed, 90(6), 121-128. Hack, M., Taylor, H. G., Drotar, D., Schluchter, M., Cartar, L., Andreias, L., et al. (2005). Chronic conditions, functional limitations, and special health care needs of school-aged children born with extremely low-birth-weight in the 1990s. Jama, 294(3), 318-325. Taylor, H. G., Espy, K. A., & Anderson, P. J. (2009). Mathematics deficiencies in children with very low birth weight or very preterm birth. Dev Disabil Res Rev, 15(1), 52-59. Morse, S. B., Zheng, H., Tang, Y., & Roth, J. (2009). Early school-age outcomes of late preterm infants. Pediatrics, 123(4), e622-629. Petrini, J. R., Dias, T., McCormick, M. C., Massolo, M. L., Green, N. S., & Escobar, G. J. (2009). Increased risk of adverse neurological development for late preterm infants. Journal of Pediatrics, 154(2), 169-176.

     

     



AlbertEinstein_iconOne of the greatest minds in history, Albert Einstein was born preterm.

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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 


Read More: Defining Preterm birth


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