What are preterm deliveries? Hyderabad doctors warn of risks, call for specialised care

Hyderabad: Several reports have emerged of Indian parents in the USA opting for forced preterm delivery, after the announcement of birthright citizenship by president Donald Trump. Preterm deliveries are common but have several short-term and long-term effects on the mother and child.

What is preterm delivery?

The normal gestation period is 40 weeks or 280 days from the first day of the last menstrual period of the woman.

Dr Annie Pranutha, consultant obstetrician and gynaecologist at BirthRight by Rainbow Hospital said, “A baby born after 37 completed weeks is called a term baby. Babies born before 37 completed weeks are known as preterm babies and those born before 30 weeks are extreme preterm babies.”

Why do preterm deliveries occur?

Preterm deliveries can happen due to multiple reasons, including when there is no external intervention and for the medical conditions of the foetus and mother. Most babies go on to lead normal lives, but a few face certain limitations.

The delivery can be spontaneous or forced depending on various factors. Most preterm babies and their mothers go through difficult phases, mentally and psychologically. Essential medical care, facilities and counselling are required to bring them out of the testing times and lead a normal life.

Spontaneous preterm delivery

Preterm delivery can happen due to various reasons and circumstances.

“When preterm delivery occurs without external intervention, it is called spontaneous preterm delivery. Some women may go into labour due to ruptured membrane or infection before the completion of 37 weeks and deliver the baby,” Dr Annie said.

Forced preterm delivery

In certain conditions, delivery is induced before the completion of 37 weeks of gestation.

“This is done due to maternal or foetal reasons. The mother may have uncontrolled and high blood pressure and diabetes or the baby could be in some distress. For the safety of the mother and baby, forced preterm delivery is induced,” Dr Annie added.

Problems faced by mother and baby

Both spontaneous and forced preterm deliveries can affect the mother and baby. Both go through physical and mental challenges, short-term or long-term, and require appropriate intervention to overcome the problems.

Dr Annie explained the immediate challenges faced by preterm babies: “The babies will have underdeveloped lungs and would require respiratory support and even a ventilator at times. The babies would not be able to suck or swallow and need feeding tubes. The underdeveloped brain can lead to brain bleeds also,” she said.

There can be difficulty in thermo liberation resulting in poor temperature control and lower immunity in children. The mothers, too, face difficulties, including under-preparedness leading to anxiety, emotional distress and guilt.

“Further, the separation of babies can result in separation anxiety in the mother. They also face complications and pain due to the Cesarean procedure,” Dr Annie said.

Long-term challenges of babies

Though forced preterm deliveries are intended to protect the mother and baby, they can cause long-term repercussions for the baby.

“Some babies can suffer from learning difficulty, developmental delays including speech delay, motor skills, hearing and visual difficulty and problems in articulation while some babies can be hyperactive as well,” Dr Annie said.

On the other side, mothers feel a lack of bonding with the baby and exhaustion due to forced preterm deliveries. “More care, attention and medical support are required for babies born before 30 weeks. This includes availability of expertise and facilities,” Dr Annie said.