Preemie Birth Risks

Children born early face a fight from the start

by Jennifer Fallon | Updated 01 Sep 2016 at 5:03 PM

Karisa Burns of Phoenix, Arizona, was only 25 weeks pregnant with her twins when the doctors discovered an infection that meant she would have to deliver the babies early.

Her twins, Connor and Mckenna, were born at about a pound and a half each. Their eyes weren’t even open yet.

Over the next few weeks, the babies required multiple blood transfusions and surgeries. The worried father, Eric Burns, recalls how hard that was to endure. 

"Their veins are so small that it’s really tough to get the needle in," he told LifeZette. "Sometimes (the doctors) would have to poke them four or five times, and the babies would squirm and scream."

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The Burns twins were in the NICU for four months. Nearly 6 years old now, they have had only minor side effects from their traumatic beginnings.

For Eric Burns, the twins’ relative good health is a miracle. He knows other people with premature babies whose children later suffered from blindness, deafness, or cerebral palsy.

One in every nine infants now born in the United States is premature, and while the treatments for these infants is steadily improving, the risks remain high even after the babies leave the NICU.

Recent research, in fact, from Washington University School of Medicine in St. Louis, Missouri, shows that premature birth is associated with weakened brain networks.

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Dr. Christopher Smyser, a professor of pediatric neurology, used MRIs to compare 58 babies born at full term with 76 infants born at least 10 weeks early. The full-term babies were scanned within three days of birth; the premature babies were scanned within a few days of their original due date.

Sensory development and plasticity of the brain is greatly affected by painful stimuli.

The images showed weakened brain networks in the premature infants, especially those networks connected to attention, communication, and emotion. Smyser told LifeZette that prematurity seems to indicate weakened gray and white matter in the babies’ brains — both the actual brain cells and the neurological connective tissue.

The weakened networks could place these babies at risk for developing cognitive difficulties, motor skill problems, ADHD, and autism spectrum disorders.

Yet Suzanne Staebler, associate clinical professor at Emory University Nell Hodgson Woodruff School of Nursing in Atlanta, Georgia, said prematurity is not necessarily the cause.

"The issue isn’t so much prematurity," she told LifeZette. "The issue is the impact of the different therapies that has to occur for these children to survive."

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She said the sensory development and plasticity of the brain is greatly affected by painful stimuli. When a child develops normally in utero, those painful interventions are minimized.

But babies born early have to undergo a plethora of painful stimuli — breathing tubes, feeding tubes, IVs, and sometimes even surgeries.

"Their brain stem is immature," Staebler said, "and how they process that stimulation is immature. They have a hyperattenuated response even over and above what we expect, and that impacts how those sensory pathways are laid down."

Staebler said most NICUs try to mimic the intrauterine experience as much as possible by providing an environment with dimmed lights, high humidity, and noise sensors so these babies can develop as normally as possible.

They have even discovered that sucking on a pacifier with sucrose can help dull the pain response in babies, which comes in handy when IVs need to be placed repeatedly.

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Prematurity has its risks, but even if your children are born premature, Smyser doesn’t recommend parents start watching for whether they exhibit symptoms of psychiatric disorders.

"The most important thing for a parent is to be a mom or dad," he said. "Leave the symptom observations to the doctors and just love and nurture the child."

Although their time in the NICU was difficult, Karisa Burns said it helped them be better parents.

"Situations like that really help to put things in perspective and help us remember what matters most," she said. "It makes me want to be a better person and enjoy my kids more."

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  2. prematurebabies
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  4. research