What Can the Future Look Like After a Preterm Birth?

A child's birth is usually a time of excitement and joy, but sometimes life takes an unexpected turn. When your little one is born too soon, you may be left wondering what the future will hold for your family. And if your baby needs to spend time in the NICU, leaving the hospital without them can break your heart. Nothing can really prepare a family for a preterm birth, but it helps to know what possible issues may arise and what the future may hold for your family.

What is a Preterm Birth?

Babies are typically fully developed and ready to be born between 37 and 42 weeks and called “full term” after 39 weeks. However, sometimes a woman’s body has difficulty carrying a baby to term, or a doctor needs to deliver a baby early due to safety concerns for the mother or infant. Any birth before the 37-week mark is called a preterm, or premature, birth. Around 12 percent of all births happen before 37 weeks of pregnancy (Pennsylvania is lower than the national average, at 9.5 percent).

What Causes a Preterm Birth?

In general, preterm births can be grouped into two categories - medically necessary, and spontaneous. 

Medically necessary preterm births are usually a result of medical conditions that threaten either the mother or the child's life. Some reasons for medically necessary preterm deliveries include pre-eclampsia, eclampsia, previous uterine rupture, intrauterine growth restriction, or abnormal umbilical cord blood flow. 

Spontaneous preterm births are not always clearly understood, but many risk factors have been identified. Things like poor nutrition, tobacco use, poor dental health, a previous preterm birth (either by the mother or by one of her family members), being a young or older mother, being pregnant with multiples, and being Black are all significant risk factors for a preterm birth.

What Problems May a Preterm Infant Face?

Unfortunately, premature birth (and its multitude of complications) is currently the leading cause of childhood mortality through age 5 throughout the world, and that’s no different in Pennsylvania. Premature babies are born before their body and organ systems have fully matured, so they can face many challenges in the short term as they struggle to fully develop outside of the safety of the womb. Infants born before 28 weeks are at the greatest risk for complications. Many preterm babies have no issues after the first couple of days, but one or more of the following problems can occur in any infant born preterm.

• Low birth weight- Insufficient fat stores mean that the infant can’t properly regulate their body temperature, and blood sugar can drop dangerously low between feedings.
• Immature lungs- Some infants may be unable to breathe effectively on their own, resulting in low blood oxygen levels.
• Underdeveloped heart- Infants can have heart rate/conduction abnormalities, low blood pressure, and are frequently born with patent ductus arteriosus, or PDA, a hole in the heart with which most infants are born. It can take longer to close in premature infants than in babies born at term, and may require medical intervention.
• Underdeveloped liver- Jaundice (yellow skin) usually clears up in a couple of days for term infants, but may take significantly longer in a preterm infant. An immature liver may be unable to clear bilirubin from the blood, which is a toxic byproduct of red blood cells as they are destroyed and replaced.
• Incomplete maternal iron transfer- Much of a baby’s iron stores (used to make red blood cells) are transferred from mother to baby in the final weeks of pregnancy. If the baby is born before enough iron has been transferred, they may not make enough red blood cells, resulting in anemia.
• Immature kidneys- When an infant’s kidneys are required to start working before fully developed, they can be much more susceptible to kidney damage or disease.
• Feeding problems- The sucking reflex doesn’t develop until 32-36 weeks of development, so premature infants are usually unable to eat on their own and require a feeding tube until this reflex is strong enough to make sure they can sufficiently feed on their own.
• Underdeveloped nervous system- Many preterm infants, particularly those born before 30 weeks, are at a higher risk of having seizures or bleeding in the brain. Apnea (periods where they stop breathing) is also common, as the part of the brain that signals the lungs to breathe continuously are not yet fully developed.
• Poor immune system- A premature immune system can take several weeks, or even months, to properly develop. In addition, preterm babies may have missed out on some or all of the mother’s antibody transfer (an added layer of immune system protection), which usually occurs over the last few weeks of pregnancy.

In addition to all of these challenges that infants face in the days and weeks after a preterm birth, children born prematurely also have an increased rate of disease and death through age 5.

Once children make it past the immediate risks that follow their birth and early childhood, some will have lifelong health problems such as cerebral palsy, learning difficulties, developmental delays, behavioral problems, chronic lung disease, vision impairment, and hearing loss. Women who were born preterm themselves also have an increased risk of delivering a preterm baby in the future.

What Problems Can a Mother Face After a Preterm Delivery?

Delivering a baby prematurely is risky for the infant, but most people are not aware of the problems a mother faces after delivering a baby too soon. According to reports from the World Health Organization, women who deliver preterm, especially extremely preterm (before 27 weeks) have an increased risk of developing heart disease or diabetes in later life. But the reason for this isn’t well understood. Women are also at greater risk of developing anxiety and postpartum depression after a preterm birth. 

In addition to these potential health consequences, there are significant financial difficulties that can plague a family after a preterm birth. It’s well known that a typical birth is expensive, and prices can vary greatly depending on insurance, the hospital, and what interventions were needed. Most recent estimates show that the pre-insurance rate for a typical labor and delivery in Pennsylvania is just over $19,000. Preterm delivery costs are much more difficult to determine as it will vary dramatically depending on the level of prematurity. Current estimates place the pre-insurance cost of a preterm delivery (and the subsequent care in the NICU if needed) somewhere between $65,000 and $145,000. The price increases significantly for children born earlier (a single day in a NICU costs about $3,000 on average). Nationwide, Americans spend $26.2 billion on preterm births each year. 

When Should I Consider Consulting With an Attorney?

A child's birth should be a happy time, but a preterm birth can turn some of that happiness into fear, distress, and uncertainty about the future. Many preterm births are unavoidable, unexpected, and unexplainable. However, when a preterm birth could have been avoided, or when the care that an infant received did not follow current medical guidelines, there may be grounds to seek compensation. Preterm births can have serious, often life-threatening consequences for an infant, and the financial burden associated with a preterm delivery can also be substantial. If a doctor could have done something to prevent or delay a preterm birth and failed to act, they may be held liable in a malpractice lawsuit.

Suppose you or your loved one has suffered medically or financially due to an avoidable preterm birth or inadequate treatment. In that case, the experienced lawyers at Ross Feller Casey may be able to help. Our dedicated team has extensive experience with both birth injury and medical malpractice lawsuits, and we have recovered over $1 billion for our clients over the past 5 years alone. We have exceptional doctor-lawyers on staff, so we understand the complex medical challenges that your child and your family may be facing down the road as the result of a preterm birth. 

At Ross Feller Casey, we work on a contingency basis. This means that we don’t get paid unless you win. Please call or contact our office today to set up a free consultation.