Neonatal Births:
Premature Babies
Ana Martinez,
Sarelia Mora,
Olivia Russell
Research
● Full term: 38-40 weeks
of being in the womb
● Late term: 41 + weeks
● Preterm: before 37
weeks of being in the
womb
● Extremely preterm:
before 28 weeks
● Very preterm: 28-32
weeks
● Moderate to late
preterm: 32-37 weeks
Statistics
● 1 in 10 babies born in the U.S are born
prematurely
● 15 million babies worldwide
● Second leading cause of death
● one-half of disabilities in children are due
to prematurity
Research
● Maternal Factors :
○ Preeclampsia
○ Chronic Medical Illnesses
○ Infections
○ Drug Abuse
○ Maternal Age
○ Abnormal Structure of the Uterus
○ Cervical length
○ Previous Premature Birth
Research
● Pregnancy Factors :
○ Abnormal or decreased function of
the placenta
○ Placenta Previa
○ Placental Abruption
○ Infections
○ Premature rupture of membranes
○ Hydramnios
.
Research
● Fetus Factors :
○ Fetal behavior can indicate if the
environment is not healthy
○ Multiple gestation
○ Erythroblastosis fetalis ( blood group
incompatibility)
History
● In the 19th century the Neonatal
Intensive Care Unit (NICU) was
invented in Europe
Today
● Health care providers have been able to prevent prematurity while the baby is
still in the womb
○ Progesterone
○ Cervical Cerclage
○ Tocolytic drugs
● Been able to keep babies alive as early as 21 weeks if they are born prematurely
○ Neonatal Intensive Care Unit (NICU)
21 week old preemie survives
● Courtney Stensrud gave birth to her very little girl at just 21 weeks and four
days gestation
● At two years although she was small for her age but yet did not develop any
further complications such as visual or auditory impairment and cerebral palsy
● She is now 3 years old and attending preschool just like any other 3 year old
Sidney Miller
https://www.pbs.org/wnet/religionandethics/1999/10/22/o
ctober-22-1999-premature-babies/20343/
Laws
● The PREEMIE
Reauthorization Act of 2018
○ reauthorize federal
research, education and
intervention activities
related to preterm birth &
infant mortality
Viable Fetus
○ Sustaining life outside the womb,
with or without medical assistance
○ In the US, for most hospitals the age
of viability is 24 weeks
○ The age of viability is set higher
(28-30 weeks) in less developed
countries due to lack resources and
technology
The US, UK & Mexico
● Guidelines for resuscitation
○ 24 weeks- Doctors will use intensive medical
intervention
○ 23-24 weeks- “gray zone” area- most doctors won’t
intervene
○ 23 weeks- most doctors won’t resuscitate the baby
● Non-initiation of resuscitation if:
○ Gestation age fewer than 23 weeks
○ A birth weight less than 400 grams
● Euthanasia is not allowed
The Netherlands
● Babies born before 25 weeks are offered palliative care rather than intensive care and
are allowed to die in the delivery room
● Severely disabled babies with low chance of survival may be legally euthanized
○ When doctors and parents agree
○ Groningen Protocol
■ July 2005
■ Four requirements:
● The presence of hopeless and unbearable suffering.
● The consent of the parents to termination of life.
● Medical consultation having taken place.
● Careful execution of the termination.
■ Doctor reports →medical examiner → district attorney & review committee
Pros Cons
● Your baby remains alive ● Expensive
● You live without guilt of letting ● Not guaranteed baby will survive
your baby alive long term
● There’s a slight chance they ● May have developmental delays
won’t develop any severe and disabilities
disabilities in their future ● Long & short term effects
Short-Term
Effects
● Jaundice
● Kidney Problems
● Infections
● Breathing Problems
● Heart Problems
Long-Term Effects
● Cerebral palsy
● Vision Problems
● Hearing Problems
● Behavioral Problems
● Impaired Cognitive Function
● Chronic Health Problems
Financial costs
● A baby born after the 37th week of pregnancy is less costly to the health care
system
○ Over the first year of a premature babies life the average cost of medical care is about $49,000
○ Over the first year of a baby born after the 37th week of pregnancy an average middle-income
family will spend $12,000
Religious Beliefs
● Most religions believe that all measures should be done to save a baby
disregarding the risk that the child may experience an unpleasant life.
Moral Code
● The most favorable opinion of society is to resuscitate the baby after it is born
prematurely
Societal Impact
● In the year 2007 the Institute of Medicine concluded that the costs for
premature births in the United States was roughly 26.2 billion each year
○ $16.9 billion in medical and health care costs for the baby
○ $1.9 billion in labor and delivery costs for mother
○ $611 million for early intervention services
○ $1.1 billion for special education services
○ $5.7 billion in lost work and pay for people born prematurely
Future Implications
● When premature babies grow up into their 20’s and 30’s they will not be able to
provide for themselves
○ They rely on the government for
■ their income
■ Assisted living
■ Medical expenses
● Medicaid and medicare
Discussion Questions:
● Should parents be able to sue doctors who saved their children against their
wishes?
● What laws do you think should be put into place regarding premature birth?
● Who should be responsible for informing the parents of the outcomes and
consequences of maintaining a premature baby alive?
● What should be done in the case where the doctors and parents don’t agree on
what to do in terms of maintaining a premature baby alive?
Resources:
https://www.cnn.com/2017/11/08/health/premature-baby-21-weeks-survivor-profile/index.html
https://www.marchofdimes.org/mission/the-economic-and-societal-costs.aspx
http://www.cnn.com/2009/HEALTH/03/17/premature.babies/index.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516104/pdf/jima-43-3-8972.pdf
https://www.who.int/news-room/fact-sheets/detail/preterm-birth
https://www.babymed.com/what-is-a-viable-nonviable-periviability-viability-pregnancy
https://www.newscientist.com/article/dn10577-when-premature-babies-should-be-allowed-to-die/
https://www.theguardian.com/society/2006/nov/16/health.medicineandhealth
https://www.bbc.com/news/health-12625253
http://www.nbcnews.com/id/6621588/ns/health-childrens_health/t/netherlands-grapples-euthanasia-babies/#.XLOZPJhKjIU
Resources:
https://theconversation.com/withdrawing-treatment-from-premature-babies-when-doctors-and-parents-disagree-11913
https://www.healthline.com/health/pregnancy/premature-baby-complications#global-impact
https://americanpregnancy.org/pregnancy-complications/cervical-cerclage/
https://www.marchofdimes.org/complications/progesterone-treatment-to-help-prevent-premature-birth.aspx
https://nyulangone.org/conditions/preterm-labor/treatments/medical-treatment-for-preterm-labor
https://www.pregnancybirthbaby.org.au/neonatal-intensive-care-unit
https://www.stanfordchildrens.org/en/topic/default?id=the-neonatal-intensive-care-unit-nicu-90-P02389
