Premature Definition Based on Weeks of Gestation
Premature Definition: When is a Baby Premature
​What is a Premature Baby?
A premature baby, also known as a preterm or preemie baby, is born before the completion of 37 weeks of pregnancy. Normally, a full-term pregnancy lasts about 40 weeks. Premature babies are categorized based on their gestational age:
-
Extremely preterm: Babies born at or before 28 weeks of gestation.
-
Very preterm: Babies born between 29 and 32 weeks.
-
Moderate to late preterm: Babies born between 33 and 36 weeks
​
Premature or early delivery can present significant health challenges for a newborn baby. Crucial organs such as the brain, lungs, and liver are still maturing during the final stages of pregnancy. For example, a premature baby might have challenges maintaining body temperature, feeding, and could be at risk for developmental delays as they grow.
How Common is Premature Birth in Canada?
Every year, 30 000 babies are born prematurely in Canada which is 8.3% of births (The Daily — Births and stillbirths, 2023).
What Causes Premature Births?
Premature birth can be caused by a variety of factors, and often babies are born prematurely due to a combination of issues rather than a single cause. Some common factors that can lead to premature birth include:
-
Multiple pregnancies (twins and triplets)
-
Infections and chronic conditions: such as uterine, bladder or kidney infections, high blood pressure, kidney disease or diabetes
-
Previous premature births
-
Certain lifestyle factors: Smoking, drug or alcohol use
-
Inadequate prenatal care
-
High levels of stress or depression
-
Pregnant person was born preterm
-
Had a pregnancy less than 12 months ago
-
Experience vaginal bleeding during pregnancy
-
Have had surgery to remove part of your cervix
-
Are overweight or underweight before pregnancy
Some premature births happen without any known cause, even when the pregnancy has been carefully managed and the pregnant person is seemingly healthy. This is why prenatal care is crucial, as it can help identify and manage risks that may lead to premature birth. More information can be found here.
What are the Challenges for Premature Babies?
Premature babies face several potential health risks, which depend on how early they are born and their birth weight*:
​
-
Respiratory problems: Due to underdeveloped lungs, many preemies have breathing difficulties, often requiring respiratory support like medication or a ventilator.
-
Infections: The immune system may be weaker, making premature babies more vulnerable to infections.
-
Temperature regulation: Premature babies can have difficulty maintaining their body temperature.
-
Jaundice: An immature liver can cause jaundice, where the skin and eyes turn yellow.
-
Feeding issues: Premature babies may have difficulty coordinating their breathing, sucking and swallowing which can affect their ability to feed.
-
Brain and nervous system: Premature babies are at higher risk of bleeding in the brain or having longer-term developmental issues as their nervous system is still developing.
​
They may need to spend time in a Neonatal Intensive Care Unit (NICU) or a specialized nursery.
​
*Low birth weight includes babies weighing less than 5 lbs. 8 ounces (2500 grams) at birth. An average full-term newborn usually weighs about 8 pounds. A low-birth-weight baby may be healthy even though he or she is small. But a low-birth-weight baby can also have many serious health problems. These babies look smaller than babies of average birth weight. A low-birth weight baby’s head may look bigger than their body and they often look thin with little body fat.
How Long Do Premature Babies Stay in the NICU?
The stay in the NICU (Neonatal Intensive Care Unit) varies based on the baby's health and gestational age at birth. Babies typically go home when they are approaching their due date, they are breathing and feeding well and have stable vital signs.
How is Prematurity Treated?
Premature babies are cared for in the NICU with a variety of approaches aimed at supporting the baby’s development and addressing any health complications associated with early birth. Here are some common strategies used for premature babies:
-
Incubators or Warmers
-
Respiratory Support: For example, oxygen, CPAP, medication, ventilation
-
Nutritional Support: For example, IV fluids, Total Parenteral Nutrition (TPN), Gavage or tube feedings
-
Monitoring of Vital Signs
-
Intravenous Fluids (IV) and Medications
-
Light Therapy: For jaundice
-
Developmental Support: For example, positioning and nesting, light and noise management, developmentally appropriate stimulation
-
Family Support and Education
-
Kangaroo Care: Skin-To-Skin
-
Family Integrated Care (FI Care): parents are encouraged to take a more hands-on role in their baby’s care, contributing to feeding, diaper changes, daily care routines, participate in medical rounds and make informed decisions with the team. This involvement can help parents gain confidence and improve outcomes for the baby.
​​
These strategies are tailored to each baby based on their specific needs and their degree of prematurity. The goal is to support the baby’s development to the point where they can thrive outside the hospital environment.
​
Can you Prevent a Preterm Birth?
Preventing preterm births is a complex issue with various strategies depending on the risk factors present. Here are some general approaches that can help reduce the risk of preterm birth:
Prenatal Care: Early identification and management of potential problems can prevent complications that might lead to preterm labor.
-
Lifestyle Modifications: This includes avoiding smoking, alcohol, and illicit drug use; managing stress; and maintaining a healthy diet and weight.
-
Managing Chronic Conditions: Conditions like diabetes, hypertension, and autoimmune disorders increase the risk of preterm birth.
-
Education and Support: Informing expectant persons about the signs of preterm labor and providing timely access to healthcare can be crucial.
-
Progesterone Supplements: For people who have had a previous preterm birth or who have a short cervix, progesterone supplements might be recommended.
-
Cervical Cerclage: a surgical procedure known as cervical cerclage might be recommended to close the cervix and prevent early opening, which can help prolong the pregnancy.
-
Aspirin – May be recommended for certain conditions.
-
Addressing Infections
​
Each case is unique, and strategies are often tailored to the specific risk factors and health status of the pregnant person. It's essential for a pregnant person to work closely with their healthcare providers to determine the best preventive measures for their individual situation.
​
Can Premature Babies Have Fulfilling Lives?
Advances in neonatal care have significantly increased the survival rates and health outcomes for premature babies. While premature babies may face more health challenges early in life compared to those born at term, many of these challenges can be managed with proper intervention and medical care.
As they grow, some children might experience delays in development and/or learning or other health issues, but with the support of healthcare providers, therapists, and educational specialists, they can live fulfilled lives. Families and caregivers play a crucial role in providing a supportive environment to help these children thrive. Parents and adults who were born preterm tell us with the right opportunities and proper care they can achieve their personal, educational, and professional goals.​
What adults born prematurely have to say: Preemie Voices Project
Experience the journeys of individuals born prematurely in this video and book by Dr. Saroj Saigal, an esteemed and award-winning neonatologist from McMaster University. Featuring narratives from adults who were among the earliest to receive care in the newborn intensive care unit at McMaster University Hospital in Hamilton, Ontario, this work delves into their lives. Born weighing less than two pounds, three ounces, these individuals share their unique challenges and triumphs, offering inspiration and hope to others.
Canadian Resources for Families with Premature Babies
Canadian Premature Babies Foundation (CPBF): Offers support, resources, and information to parents of prematurely born children.​
Family Integrated Care: FICare programs, implemented in many Canadian NICUs, empower parents to take an active role in their baby’s care. The program provides education, emotional support, and engagement for families with babies in the NICU.
Ronald McDonald House Charities Canada: Provides accommodations near hospitals for families with children in the NICU, including preemies. Their services allow families to stay close to their babies during extended hospital stays.
Our Kids Health Preemie Hub (launching soon)
This information aims to provide a broad understanding of premature births, their implications, and resources available in Canada to support families. Please speak to your health care providers for more specific information.
If you are navigating the journey of having a premature baby, we want you to know that you're not alone. We understand the challenges and emotions that come with this experience, and we're here to support you every step of the way. Our community is built on compassion, understanding, and shared experiences. Whether you need resources, guidance, or just a listening ear, we are here for you. Together, we can provide the care and support your little one needs to thrive.
Preemie Chats