The sense of touch develops around the mouth area as early as eight weeks, and at 20 weeks skin receptor cells are in place all over the body. At 24 weeks the fetus already responds to touch of the palm with a weak grasp and at 26 weeks, the palmar grasp reflex will be stronger. The baby will hold onto anything placed in her palm, such as the umbilical cord, when still in utero or dad’s finger after birth.
Other reasons may include pre-eclampsia and HELLP syndrome. A condition more often seen is premature rupture of membranes, which may result in oligohydramnios and infection. Bleeding of the placenta may also be a reason for premature delivery, such as in placenta-previa, placenta abruption, or injury to the abdomen in case of a motor vehicle accident. Finally, fetal abnormalities might also be cause for premature birth.
Other risk factors include previous preterm birth, miscarriage or multiple abortions, urinary tract infections, vaginal infections, sexually transmitted infections and possibly other infections. History of kidney disease, uterus and cervical abnormalities, such as cervical incompetence, diabetes, clotting disorders, being pregnant with a single fetus after in vitro fertilization (IVF), being underweight before pregnancy and low weight gain during the pregnancy. Also contributing to prematurity is obesity, short time period between pregnancies (less than 6-9 months between birth and the beginning of the next pregnancy) and intrauterine growth restriction. Increased caesarean births and induction also seems to contribute to prematurity.
Lifestyle and environmental risks that may put mothers at greater risk for preterm labour include: late or no prenatal care, smoking during pregnancy, drinking alcohol, using illegal drugs, physical environment such as lead paint, crowding and pollution; domestic violence, including physical, sexual or emotional abuse, lack of social support, long working hours with long periods of standing and stress. More mothers have high-profile jobs that may cause unnoticed physical and emotional stress. High levels of stress hormones, cortisol, cross the placenta and may result in prematurity and fussy, irritable babies. Due to the improvements in the medical science it is more often possible to prevent miscarriages and this may lead to lengthening the pregnancy until the baby is viable, however premature.
Immature lungs and brain cause some complications of preterm birth. This includes temperature instability, feeding difficulties, breathing problems (Respiratory Distress Syndrome and chronic lung problems), tachypnea of the newborn, retinopathy of prematurity, necrotising enterocolitis and jaundice. The premature infant is also at risk for physiological, emotional, neurosensory, developmental and psychosocial development problems due to the extrauterine demands made on the central nervous system (CNS) that is not yet prepared for this environment. Premature babies may also be at risk for hearing loss due to immature development and exposure to a compromising environment, such as the NICU and noisy incubators, infections in utero, high bilirubin levels, treatment with certain antibiotics and severe asphyxia, caused by periods of too little oxygen.
Later developmental problems may include mental and neurological problems, such as cerebral palsy, visual, hearing, and motor deficits, poor emotional regulation, as well as emotional vulnerability and difficulties with self-regulation and self-esteem. Attention problems and language delays leading to learning disabilities, lower IQ, impaired executive function and attention deficit disorders. Prematurity may also lower the fatigue thresholds that may influence activities of daily living, distractibility, impulsivity, concentration difficulties, spatial processing disturbances, language comprehension and speech problems. Premature babies experience more health problems, such as asthma, upper and lower respiratory infections and ear infections. Premature babies may be at risk for these developmental problems, but that is not a given that all premmies will experience all these problems, if any.
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