Increasing Maternal Age and Premature Birth
According to the World Health Organization, there are fifteen (15) million premature births every year. Premature births are the leading cause of death among children under five (5) years. Children who survive prematurity face lifelong complications such as difficulty in learning as well as poor health. Recently, women have increased the age at which they bear children. Older women have been found to have more premature babies as compared to their younger counterparts. This is because women over forty (40) years are more likely to have conditions that cause complications in pregnancy, thus require preterm delivery.
Overview of Preterm Births
A baby is considered premature if they are born in, or before thirty-seven (37) weeks of gestational age. The rate of premature births is rising in America as a result of both maternal and fetal conditions. About twelve (12%) percent of all babies born in the United States are preterm. This is according to the National Centre of Health Statistics. 1.5% of these babies are or between thirty-two (32) and thirty-three (33) weeks gestational age. Those born below thirty-two (32) weeks are about two (2%) percent, whereas those born between thirty-four (34) and thirty-six (36) weeks are eight (8%) percent.
Most premature babies have a birth weight lower than two thousand five hundred (2,500gm) grams, which is low birth weight. Premature babies born between thirty-four (34) and thirty-seven (37) weeks, also known as late preterm, are almost similar to term babies in appearance as well as body weight. This makes it easier for them to adapt to normal conditions outside the womb. Due to their size, preterm babies have some trouble maintaining a constant body temperature that’s why they need to be put in an incubator where temperatures can get regulated.
Preterm babies have a higher risk of infection compared to term babies. This is because their immunity and major organs are not completely developed. Preterm babies should be monitored continuously in a health facility, and they need to meet specific conditions before being released to go home.
One of the common factors contributing to poor childbirth outcomes is maternal age. Most preterm babies are born to teenage mothers as well as older mothers over the age of forty (40) years. Therefore, as a mother over the age of forty, it is important to have a good Los Angeles Childbirth doctor and get regular check-ups.
What Causes Premature Births in Older Women?
There are numerous factors linked to prematurity in babies or to mothers who are over the age of forty (40) years. Some conditions make the mother unfit to continue the pregnancy, forcing the doctors to perform an early birth. Other factors directly cause premature birth by sending the mother into early labor.
Assisted Reproductive Technology
This is the medical technology used to treat infertility. In vitro fertilization (IVF) is the most common method used in the United States. For IVF, both the woman’s egg and the man’s sperm get removed from the body and fertilization is done outside the woman’s body. After fertilization, the embryo is put back in the woman’s body to develop.
Advanced maternal age is one of the most challenging aspects of childbirth and reproductive health. In the United States, marriage and childbearing age are increasing for women. Additionally, single women in their forties are continually seeking to have their children. The fertility of most women declines with, increased age due to the depletion of ovarian follicle reserve. This shortens the menstrual cycle, thus decreasing the Follicle Stimulating hormone in the woman’s body. A decline in the reproductive system performance is acute in the fourth decade of the woman’s life.
However, women of advanced age are eager to conceive on their own. Since natural conception becomes difficult at some age, they have to seek assisted reproduction to bear children. The most common complication associated with assisted reproductive technology is multiple births. A woman who has undergone IVF is likely to have more than one baby. As a result of the multiple births, the babies have a fifty (50%) percent likelihood of being preterm. Therefore, it is important to consult a Los Angeles Childbirth expert when you are expecting a child at an advanced age.
Abnormalities of the Reproductive System
The female reproductive system is a complicated part of the body. Like other body functions, the risk of complications in this system increase with the age of the woman. Women with particular difficulties with their reproductive system are likely to give birth prematurely. Some of the abnormalities include short or incompetent cervix. An incompetent cervix occurs when the uterus becomes weak and starts opening gradually before thirty-seven (37) weeks of pregnancy. When this happens, a woman goes into premature labor, thus giving birth before thirty-seven (37) weeks gestational age. Other reproductive formalities include the genetic disorders that affect the fibrous protein, which supports your connective tissues.
As women age, their bodies become more delicate, and it may be difficult for their reproductive system to hold the pregnancy to full term. There is an increasing prevalence of hormonal imbalance in older women compared to younger ones. To maintain the pregnancy to the end, the level of progesterone should be sufficient. An imbalance in these hormones may send the woman into early labor resulting in a preterm baby.
High Blood Pressure During Pregnancy/Preeclampsia
This occurs when a woman’s blood pressure is very high during pregnancy. This condition may be preexisting or occur during pregnancy. Gestational hypertension only occurs after twenty weeks (20) of pregnancy and is likely to cause numerous complications. Preeclampsia may be a sign that some organs are not functioning correctly. Symptoms of high blood pressure in pregnancy include protein in the urine, changes in vision as well as severe headaches. High blood pressure can be fatal to both the mother and the fetus; thus, doctors opt to carry out early births to save their lives.
Women who conceive past forty (40) years are more prone to Preeclampsia as compared to their younger counterparts. Most of these women tend to have scheduled Cesarean Sections before thirty-seven (37) weeks; thus, they deliver preterm babies.
Maternal Overweight and Obesity
Obesity is a condition where an individual has excessive body fat. This predisposes said individual to other weight-related complications. Some of the fat may accumulate near vital body organs like the liver, heart, and kidney, thus affecting their function. Older women are more likely to be overweight and obese before and during pregnancy. Obesity causes numerous health complications, including heart problems, kidney failure, and diabetes. Having any of these conditions during pregnancy increases the risk of birth complications, forcing mothers to deliver before thirty-seven (37) weeks.
Premature births related to overweight and obesity get medically induced. This means that doctors may decide to induce labor well or even perform a Cesarean Section. The birth complications resulting from excessive weight makes it difficult for the mother to carry the pregnancy to term.
Gestational Diabetes
Diabetes is a condition where one’s body is unable to control blood sugar levels; thus, the sugar accumulates in the blood. This is a result of insufficient insulin produced by the body. Gestational diabetes will only develop during pregnancy and stops after delivery. Any woman can develop this condition. However, women who bear children later in life are more likely to have gestational diabetes. If you have gestational diabetes, your pregnancy may be healthy, but in some cases, severe complications are experienced.
If gestational diabetes is not diagnosed and treated early, it may cause premature birth. This is a result of birth complications such as Preeclampsia and Diabetes to the unborn baby caused by this condition. Doctors perform early delivery to protect the mother and baby from fatalities.
Characteristics of Prematurity
Although any premature baby may show a different feature of the conditions, the following are the most common:

• Small in size with a low birth weight of fewer than two thousand five hundred (2,500gm) grams
• Little body fat
• Shiny skin which is pink or red in color and veins that are easily visible
• Most have hairy bodies but less hair on the scalp
• General weakness which is indicated by a weak cry
• Small and underdeveloped genitals

Characteristics of prematurity may resemble those of other newborn medical conditions. These babies are placed in the Neonatal Intensive Care Unit, where they will require specialized attention and medical assistance to survive. Therefore, it is crucial to make sure a woman delivers in a health facility.
Short Term Complications Associated with Prematurity
Although not all preterm infants experience complications. Being born too early is likely to cause both short and long term health problems to the baby. The earlier the birth, the more the risk of complications. Some of the apparent problem faced by premature babies in the first few weeks include:

• Heart Problems

Patent Ductus Arteriosus is the most common heart condition suffered by preterm infants. This is an opening through the pulmonary artery and aorta. Even though this condition disappears over time, if left untreated, it can cause heart murmur as well as heart failure.

• Breathing Difficulties

As a result of the immature respiratory system, a preterm baby is likely to have breathing difficulties. Very preterm and extremely preterm babies lack surfactant, a substance that allows lungs to expand and contract for adequate breathing. These newborns may develop respiratory distress syndrome or even sleeping apnea.

• Difficult to Control Body Temperature

Preterm Babies rapidly lose body heat. A full term baby has fat stored on the skin, which helps them maintain constant body temperature. Infants of before thirty-seven (37) weeks gestation age have little fat stored on the skin. This makes it challenging to generate enough heat and can result in hypothermia. This condition deters the baby’s growth since they use all the energy from the feeding to stay warm. As a result of their temperature control problems, they will require additional heat from an incubator.

• Brain Problems

The brains of babies who are born early are not entirely developed. The earlier there are born, the more the risk of a brain hemorrhage. Minor bleeding resolves after a short time, but if the condition is severe, the baby may be prone to a permanent brain injury in the future.

• Blood-Related complications

Preterm babies are at risk of anemia as well as jaundice. Anemia is a condition where one has a lower count of red blood cells. In the first few months of life, all newborns will experience a slow drop in the red blood cell count. However, the decline in preemies is more rapid. On the other hand, newborn jaundice is yellowing of the skin and could be fatal for a preterm baby.

• Gastrointestinal problems

Most body functions are entirely developed at thirty-seven (37) weeks gestation. Preemies have an immature digestive tract. Also, they have a poor suckling and swallowing reflexes, which is why they need to be tube-fed until they catch up with milestone.
Preterm infants have smaller stores of glucose. Thus they are more prone to hypoglycemia. This is a condition characterized by abnormally low blood sugar levels as a result of the difficulty to convert the glucose in milk into more active forms.

• Weak Immune System

Premature babies are with an underdeveloped immune system which predisposes them to more infections. Minor infections in these newborns can rapidly turn fatal. This is because the infection will spread to the bloodstream and cause sepsis.
Long Term Implications of Premature Births
In the future life of preterm babies, they are likely to suffer:

• Impaired Learning

When it comes to achieving developmental milestones, babies or preterm are likely to lag behind their full-term counterparts. Even after attaining the school going age, these children may have difficulties learning.

• Cerebral Palsy

Cerebral palsy is a condition that hinders muscle movement, posture, and muscle tone. This condition is a result of infection, inadequate blood flow, or injury in the brain of a newborn either before delivery or early infancy. Due to the poorly developed immune function of premature babies, they are more likely to suffer from cerebral palsy.

• Chronic Health Issues

Compared to term infants, preemies are more prone to chronic health conditions such as asthma and feeding problems. Also, babies or before their time suffer a high risk of sudden infant death syndrome.

• Dental problems

Preemies who have had critical illness may develop dental problems such as delayed tooth eruption, poor alignment of teeth as well as discoloration.

• Vision Impairment

Preterm babies are at risk of retinopathy of prematurity. This is a condition where blood vessels overgrow and lock the light sensation layer at the back of the eye. Sometimes the retinal blood vessels will scar the retina and put it out of position. If it goes undetected, retinal detachment is likely to cause vision impairment as well as blindness.
Treatment for Prematurity
Preterm babies get different types of treatment depending on: The baby’s gestational age at the time of birth, as well as their overall health. Some babies have fewer complications, even if they are preterm. Specific complications that come with prematurity and their ability to tolerate medication also affect the kind of treatment to be given. The most common treatment necessary for preterm babies is prenatal corticosteroid therapy. Research shows that giving mothers corticosteroids before premature delivery reduces the risk of respiratory complications.
Also, these drugs lessen bleeding in the baby’s brain after premature delivery. However, the medication is more effective if the mother delivers between twenty-four (24) and thirty-four (34) weeks. Before and after this, prenatal corticosteroid therapy is not sufficient. Preterm babies will need some time to catch up in the growth and development before discharge from the hospital.
Depending on an individual case, a premature baby will stay under hospital care until they reach the ideal weight. The doctors will also make sure all body functions get to that of an average term child. The goals to be achieved before discharge are; resolving any serious medical condition, the ability of the infant to breastfeed or bottle-feed on their own, regular heart rate as well as stable body temperature. Addition care for these babies include:

• Getting extra oxygen and constant monitoring of breathing rates
• Temperature controlled conditions
• Mechanical ventilators which do the breathing on their behalf
• Placement of catheters through which they receive food and medication. This is because preterm babies have an undeveloped swallowing and suckling reflex and have to get fed through tubes.
• Constant administration of drugs to treat complications
• Kangaroo Care. This is a method of caring for preterm babies through the skin to skin contact. Parents of premature babies provide touch, which gives the baby heat. Babies who get constant kangaroo care spend little time in NICU.

Prevention of Preterm Births in Older Women
Some instances of premature births are spontaneous. However, some can be prevented by proper care of the mother before and after pregnancy. Women should be more aware of their health before planning a pregnancy. This will enable the control of all complications that could result in premature births. To ensure less premature births, mothers should attend prenatal clinics as soon as they test positive for pregnancy.
Visiting a Los Angeles Childbirth Center will ensure you do the right exercises during pregnancy and avoid strenuous activities that can cause premature labor. Women with a weak cervix can have the option to be fitted with cervical cerclage. This will help prevent the opening of the uterus and reduce the risk of premature births. Premature labor can be restricted by ensuring that an expectant woman avoids stressful situations.