Premature birth is the leading cause of newborn death in the U.S., with one in eight babies — over 500,000 each year — born prematurely. Premature birth can also lead to serious health complications. Through increased awareness, education, and leading-edge diagnostics and treatment at both the fetal and newborn stages of life, we can help to reduce the number of premature births in our region. Here, Shanthy Sridhar, MD, Division of Neonatal and Perinatal Medicine, and Medical Director of the Neonatal Intensive Care Unit (NICU) and Neonatal Transports discusses prematurity and neonatal and perinatal care.
What causes premature birth?
Earlier than 37 weeks of gestation is considered “premature” while between 37 and 42 weeks is considered “full-term.” No one knows for sure what causes premature birth. Some women are genetically pre-disposed to preterm labor, or have abnormalities in the uterus or a shortened, collapsed cervix that cannot hold the baby. Maternal medical conditions such as high blood pressure, diabetes, and obesity, or things such as smoking, substance abuse, and infertility treatments that result in multiples can contribute to a woman going into preterm labor.
What complications does prematurity cause?
Several complications can occur and can affect every organ in the body. The younger the infant’s gestational age, the more severe the problems.
- Respiratory distress syndrome. Lungs are in the early stages of development causing breathing difficulties that often require mechanical ventilation, surfacant, and oxygen therapy.
- Chronic lung disease. Some premature babies born less than 28 weeks require mechanical ventilation for prolonged periods and will develop scarring in the lungs. This often requires ongoing treatment with oxygen and diuretics upon discharge. Treatment may last one or more years.
- Retinopathy of prematurity (ROP). This condition results from the abnormal growth of blood vessels in the retina (eyes), which can lead to visual problems including blindness. In the most severe cases, laser therapy can stop the abnormal blood vessel growth and help prevent retinal detachment.
- Intraventricular hemorrhage. This often results in bleeding in the brain, occurring in the first three days of life. When severe, it can lead to cerebral palsy, mental retardation, visual and hearing problems, and learning disabilities.
What distinguishes Stony Brook's approach to neonatal and perinatal care?
Stony Brook Medicine is the only state-designated, regional perinatal center caring for critically ill newborns. Neonatalogists provide 24-hour in-hospital coverage for newborns’ resuscitation, and consultation services for families who deliver premature babies in Suffolk County. Annually, more than 100 infants and 200 high-risk pregnant women are transferred to Stony Brook from other hospitals in the region, and we treat more than 1000 sick newborns each year in our Neonatal Intensive Care Unit.
Our neonatal program is the only one in Suffolk County entrusted by the American Board of Pediatrics to train the neonatologists of tomorrow. We are the only center in Suffolk County that offers Selective Head Cooling therapy to term and near-term infants born with moderate to severe hypoxic ishemic encephalopathy to help prevent severe cerebral palsy and long-term developmental problems. Stony Brook is the only center offering a Newborn CPR Pilot program to help families with infants diagnosed with apnea and other breathing problems who are being discharged home. And, we are one of only two centers in New York State funded by the March of Dimes® Family Support Program, where a NICU Family Support specialist meets with staff and the families of babies being cared for in the NICU to help them through this challenging time in their lives. In spring 2011, Stony Brook became the only hospital on Long Island to offer a 46-bed, single-patient room neonatal intensive care unit to further enhance the already stellar care provided by our highly skilled team of specially trained neonatalogists, nurse practitioners and other specialists.
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