#HEALTH: When baby comes early

WHEN a baby is born prematurely, it can have a substantial emotional impact on the entire family. Preterm labour can cause anxiety, postpartum depression, post-traumatic stress disorder (PTSD) and mother-baby bonding difficulty.

Globally, according to the World Health Organisation, an estimated 13.4 million babies were born too early in 2020 or about 1 in 10 infants. Prematurity is the leading cause of death in children under five years of age and many survivors face a lifetime of disability, including learning disabilities and visual and hearing problems.

The Malaysian National Neonatal Registry (MNNR) reported 319,867 total live births in participating hospitals in 2020, of which 10.7 per cent were preterm births.

Sunway Medical Centre neonatologist and paediatrician Dr Cheong Shu Meng says preterm babies often have complications and the severity of complications is inversely proportional to the gestational age of the baby.

These include breathing problems such as respiratory distress syndrome (RDS), heart problems, bleeding in the brain, temperature instability, especially hypothermia, and feeding problems due to their immature digestive systems.

Preterm babies have a higher risk of getting infections due to an immature immune system and are more susceptible to anaemia and jaundice.

"They also have a higher risk of cerebral palsy which can cause problems with movement, muscle tone and posture, learning disabilities, behavioural problems, vision and hearing problems and poor growth."

Dr Cheong says given that preterm babies require intensive care upon birth, it's best that they be treated in a hospital that has a neonatal intensive care unit (NICU) under the supervision of a neonatologist.

Unfortunately, preterm births cannot always be prevented. However, there are steps that expectant mums can take to reduce the risk of having preterm labour. These include regular ante-natal follow-ups and good control of illnesses such as diabetes, high blood pressure, or depression.

It's also crucial that they avoid smoking, alcohol and illegal drugs and maintain a healthy diet.

"Reducing infection risks through good hand hygiene, avoiding raw meat or fish or unpasteurised cheese and not handling cat litter, also helps, as does reducing stress levels and waiting at least 18 months between pregnancies."

When a preterm baby is fit for discharge from hospital, preterm baby care counselling is also important to ensure that parents are confident of taking care of their child at home. Follow-up appointments are also crucial to monitor the growth and neurodevelopment.


PREMATURITY or preterm, is defined as a birth that occurs before 37 completed weeks of gestation.

There are sub-categories of preterm birth based on gestational age:

*Extremely preterm (less than 28 weeks)

*Very preterm (28 to less than 32 weeks)

*Moderate preterm (32 to less than 34 weeks)

*Late preterm (34 to less than 37 weeks)

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