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How baby's gestation affects their health and survival

How baby's gestation affects their health and survival


If your baby is born prematurely, or your caregiver is suggesting that delivering your baby preterm is recommended, then one of the most common concerns for parents is "Will my baby(s) be alright and will they survive?"



The health and survival prospects for a baby born preterm can depend on many factors. These can include:

The baby's gestation

The baby's 'gestation' refers their 'age' in relation to how many weeks pregnant the mother is (for example a baby born at 32 weeks in the pregnancy is referred to as a 'baby of 32 weeks gestation'). Each extra week a baby can grow inside their mother's womb will usually translate to a considerable increase in their chances for good health and survival.

The outcomes for preterm babies have improved dramatically in recent decades because of improvements in modern technology and the advancements in treatments now available. However, there are still health risks associated with being born too early and the 'older' in gestation the baby, the better off they tend to be.

Predicting how (or if) preterm babies will recover can be difficult for caregivers. They will usually advise parents to take each hour and each day, one at a time. The most critical times for the survival of preterm babies are typically the first week after birth (as well as the days or hours before the birth).

Most preterm births (80 percent) occur at around 32 to 37 weeks of pregnancy. About 20 percent of preterm births are earlier than 32 weeks. The following is a guide to the probable expectations caregivers will have for the health and survival of babies in regards to how preterm they are.

35 to 37 weeks

Babies born after 35 weeks are only mildly preterm and usually do very well. They may be small (less than 2,800 grams or 6lb 3oz) and may need extra help with feeding and keeping warm, but they are usually able to breathe on their own and will usually not need to spend much (or any) time in the Intensive Care Nursery, especially if they are feeding well and maintaining their temperature.

33 to 35 weeks

Babies born after 33 weeks and before 35 weeks are still regarded as being 'mildly preterm', but will usually require some time in the Intensive Care Nursery. This is usually for observation, monitoring, warmth in a 'humidicrib' or 'incubator' and nourishment with a drip in their vein or milk fed down a tube into their stomach.

Babies born at this time may have difficulty maintaining their body temperature, can have a weak sucking reflex and may need small amounts of oxygen for a few hours (or days). Babies born around this gestation can usually be cared for in a Level 2 nursery, which is available at most hospitals. They will generally do very well and have few complications, having a survival rate of 95 percent or more.

28 to 32 weeks

Babies born around 28 to 32 weeks are regarded as 'moderately preterm' and usually have a better chance of survival if they are born in a hospital with a specialised Level 3 Intensive Care Nursery. This is because babies of these gestations could need a ventilator machine to help them to breathe for a period of time (hours, days or weeks) after the birth. If there is a risk that your baby will be born this early then your caregiver will probably recommend that you transfer to a hospital with a Level 3 nursery (unless your hospital already has this facility).

Babies born at around 31 weeks or more have about a 95 percent chance of survival. Babies born at around 29 to 30 weeks have about a 90 percent chance of survival and babies born around 28 weeks have about an 80 percent chance of survival.

26 to 28 weeks

Babies born less than 28 weeks are regarded as 'extremely preterm'. They will most probably need a ventilator machine to help them to breathe for a period of time (up to a few days or weeks or more) and are at increased risk of developing complications or possibly having long term health problems.

In recent years, modern advances in technology have increased the health and survival rates of babies born this early. Again, if there is a risk that your baby will be born at this gestation, then your caregiver will recommend you transfer to a hospital with a Level 3 nursery (unless your hospital already has this facility).

Babies born at around 27 weeks gestation have about a 74 to 87 percent chance of survival and babies born around 26 weeks have around a 57 to 71 percent chance of survival.

24 to 26 weeks

Babies born around this time are regarded as extremely preterm and at high risk of developing complications and/or having long term health problems. About 45 to 50 percent of babies born at 24 weeks will survive and 44 to 65 percent of babies born around 25 weeks will survive. These babies need access to Level 3 Intensive Care hospital facilities to give them the best chance of survival.

Less than 24 weeks

Babies born less than 24 weeks gestation have only a very small chance of surviving (about 2 to 3 percent). Decisions regarding intensive care treatments for babies this premature need to be discussed with your caregiver.

Your caregiver may ask you at the birth if you want the staff to make attempts to try and save your baby. Alternatively, you may be advised to just wrap your baby warmly and cuddle them until they are no longer breathing. Sometimes staff will make initial attempts to save the baby (on their own judgment or the parent's request), but the decision is then made to discontinue life-saving treatments after a few hours or a few days or more. It is important that you obtain as much information as possible about the short and long term health prospects for your baby and are involved in making these decisions.

 

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