Having featured the stories of Dewi and Joycelyn, two mothers whose babies were born prematurely, we now examine the causes of premature labour and some health issues which pre-term babies face.

CAUSES OF PREMATURE DELIVERY
A study in the Singapore Medical Journal defines a premature baby as “a child born earlier than 37 completed weeks of gestation”. The article estimates that between ten and 12 per cent of the births in Singapore are premature.
Although over half of the women who deliver prematurely do not have any known risk factors, a study of 20,723 single births at NUH between January 1986 and November 1991 found that teenage mothers, women with lesser education, those with no antenatal care, and mothers who have had three or more previous deliveries have a higher risk of delivering prematurely.
In addition, the Ministry of Health’s 2001 Clinical Practice Guidelines for Management of Preterm Labour found that underweight women, smokers, those with previous pre-term deliveries, multiple pregnancies, cervical incompetence, uterine abnormalities and pregnancy complications have a higher risk of delivering prematurely.
Just as unexpectedly as premature labour begins in some mothers, Baby Centre estimates that it may also stop by itself in roughly 50 per cent of women, while premature delivery cannot be prevented in the remaining cases.
HEALTH ISSUES IN A PREMATURE BABY
As the organs and muscles of a premature baby have had less time to develop compared with those in a full term baby, premature babies may be born with health problems, or have developmental issues later in life. Depending on how early the baby was born, he or she may also have the following problems:
Apnea
As the part of a premature baby’s brain which controls breathing is not fully developed, such babies may suffer from apnea, where they may stop breathing for fifteen to 20 seconds at times. Premature babies are monitored closely, and should they stop breathing, nurses will stimulate the baby by rubbing his back, hands and legs.
Patent Ductus Arteriosus
When the baby is in the womb, its lungs are not in use as the foetus receives oxygen from the mother through its umbilical cord. Thus, blood does not need to flow from the heart to the lungs, but is diverted to the rest of the body via the ductus arteriosus, a “hole” connecting two major blood vessels.
In a full term baby, this hole normally closes substantially within twelve to 24 hours of birth, and is sealed within three weeks. However, it may remain open in a premature baby with a birth weight below 1,500 g, resulting in an incorrect blood flow. Such babies may have breathing difficulties or a heart murmur. This hole may be closed through surgery, or by giving the baby medication.
Hernia
The abdominal muscles of a premature baby may not be fully closed or sufficiently strong at the time of birth. Thus, a hernia, or lump under the skin, may be formed as a result of fluid, tissue or internal organs like the intestines protruding out of the tummy or groin through a gap in the muscles. Surgery is required to close this gap.
Retinopathy of Prematurity (ROP)
This condition occurs when the blood vessels in the eyes of a premature baby develop abnormally. Babies with a birth weight under 1,500 g are at higher risk of developing ROP.
Depending on the severity of the condition, ROP may recover by itself, require laser therapy or even surgery. In mild cases, babies may recover completely, while severe cases may lead to short-sightedness or blindness.