Contents
When do we say that a child is premature?
Prematurity concerns everyone children born before the 37th week of amenorrhea (HER). Or four weeks before the theoretical delivery date. The earlier the childbirth occurs in pregnancy, the more uncertain the survival of the child and the more serious and irremediable the consequences of this early birth. There are thus three levels of prematurity.
It should be noted
From birth, the premature newborn is treated in neonatal care.
Very premature babies
When a child is born before the 28th week of amenorrhea, we are talking about very great prematurity. At this stage of pregnancy, the fetus is far from being definitively formed. The medical teams cannot comment on his survival. One thing is certain: the bigger the baby (if it approaches 1 g), the more viable it is. The child will be transferred to a type III maternity unit, equipped with a resuscitation and neonatal unit. Placed in intensive care, in an incubator, the challenge is to allow the baby to continue his development, by trying as best as possible to recreate the conditions of the uterus.
Very premature babies
In this category fall all babies born between the 28th and the 33rd SA. 90% of children born alive survive, but the risk of sequelae remains high. Like very very premature babies, these babies are under very close surveillance, in a neonatal unit and under an incubator to allow their vital functions to mature as well as possible.
Average premature babies
They were born after the 34th week of amenorrhea and before the 37th. We always talk about prematurity, but the fetus at this stage is much better prepared to face the outside world than the two previous cases. The infant benefits from the special attention of the medical team but is rarely placed in an incubator.
Premature baby: fighting to live
The body of a baby that is born within 37 weeks is said to be immature. The newborn is not equipped to face the extrauterine world, its vital functions are not operational. Lungs, digestive system, liver and immune system of infants under 35 weeks do not function independently and must continue to develop in order for them to survive. The premature baby is also unable to regulate his temperature, which is why it is kept warm in an incubator at 35 ° C.
Premature baby: risks of sequelae
Once out of the woods, the growth of the premature baby will not be without complications. These babies are followed by specialists (ENT, ophthalmologist, neuropediatrician, etc.) to diagnose possible sequelae or, on the contrary, to observe the harmonious development of the child. Premature babies are particularly confronted with stunted growth, language learning difficulties or hyperactivity. In certain cases, in particular of very great prematurity, it will retain more or less serious and disabling consequences: motor impairment, intellectual deficit, visual disturbances, deafness, etc.
Premature babies: fatty acids lower the risk of retinopathy, a serious disease of the retina
Retinopathy of prematurity is a disorder that can affect very premature infants and cause blindness. Researchers have discovered that it would be possible to prevent the development of this disease which affects the blood vessels of the retina of the child by simply supplementing with good fatty acids.
Premature babies are more at risk of developing eye disorders, and among these retinopathy of prematurity (ROP). A disorder that affects the blood vessels of the retina, still developing for these very young infants, and may be responsible for poor visual acuity or blindness after retinal detachment. Treatments vary depending on the stage and severity. In a new study, researchers at University Hospitals in Gothenburg, Lund and Stockholm succeeded in reducing the risk by half in extremely premature infants (born before 28 weeks gestation) thanks to a supplementation combining various polyunsaturated fatty acids.
The study published in “JAMA Pediatrics” concerned 206 babies considered like very premature babies, in several neonatal departments, over a period of more than three years (2016-2019). Half of these newborns received no supplementation, while those in the other half received oral nutritional supplements, containing DHA-type omega-3s (50 milligrams per day and kilogram of body weight) combined with arachidonic acid, an omega-6 fatty acid (twice as much). A decision which may surprise since “in adults, high levels of omega-6 fatty acids are associated with inflammation and cardiovascular disease. “, Explain the researchers.
A risk divided by two
But the latter point out that in the fetal period, arachidonic acid is an essential building block of cell membranes, and acts as signaling molecules between cells. In previous studies, the scientific team had shown the link between retinopathy of prematurity and low levels of arachidonic acid in the blood of premature babies. ” Administration of arachidonic acid as a supplement has been a subject of debate, and more clinical studies on how to design an optimal blend of fatty acids have been needed. », They add. For its part, omega-3 fatty acid type DHA is a vital component of blood vessels and nervous tissue.
The results showed that in the group of infants with retinopathy having received the supplementation, or 16 of the 101 children (15,8%), developed severe ROP. The corresponding proportion in the control group of infants was 35 out of 105 (33,3%). “We are taking a step forward by showing such a marked reduction in one of the serious neurovascular complications that can occur after extremely premature labor,” the researchers say.
Scientists hope to be able to confirm these results in more depth, and to put in place a real preventive strategy, recalling that “in the world, some 20 infants become blind or suffer from a serious visual impairment each year due to ROP. Their next step will be to find the optimal composition for premature babies, the one that will give the best results for their health according to their stage of development.
Alexandra Bresson