Expert tells all about premature births

Find out what increases the chances of premature births

How do you perceive the current state of pre-term care in Singapore and what can be done to improve it?
Trend of preterm birth is on the rise. Unbooked pregnancies among expectant teens is common. All in the reproductive age should be educated on the possibility of preterm labour and advised on appropriate antenatal care when they conceive. Teenage pregnancies and increasing trend of smoking and drinking habits among woman in their reproductive age contribute sizeably to the number of preterm births. Appropiate counselling and support for these teenage mothers can help in decreasing the load of preterm births.

What are the 3 likely causes of preterm births?
a) Teenage pregnancies
b) Advanced maternal age needing assisted reproduction
c) Mothers with chronic medical conditions eg kidney failure, diabetes mellitus, connective tissue disorder eg SLE.

What are the  likely consequences of preterm births for both mother and child?
Mother
a) Filled with grief, guilt over state of newborn child
b) Depressed over uncertainty in outcome of their newborns, cost of care etc
c) Angry and sense of loss over episodes and duration of unwell in their newborn child

Child
a) Need for support to maintain cardio-respiratory stability
b) Need to maintain neutral temperature through use of incubators and also ensure optimal hydration and nutrients
c) Risk of infections, bleeding, and chronic medical complications to the lungs, eye, and neurodevelopment.

What are some new neonatal practices and how do these treatments address the consequences of preterm births?
a. Use of antenatal steroids on expectant women in preterm labour has brought about significant improvement in the severity of acute lung disease in babies born preterm.

b. The use of surfactant, a natural substance present in matured lung has helped to decrease the need for ventilatory support in babies born preterm.

c. Attention to nutrition delivered to preterm infants from birth has improved the quality of survival.

d. Improvement in intensive neonatal care, both technology and nursing care ratios for preemie babies contribute immensely to survival and quality of survivals of babies born preterm.

What kind of support in Singapore is available for parents of preterm babies?
In most Centres caring for preterm babies, there is internally support groups conducted by care team comprising of doctors, nurses and social workers as well as parent support groups, which may be formal or informal groups of parents with ex- preterm babies. Some Centres may also identify themselves with community organization which will continue to support these families as their children graduate from the nurseries.

In SGH, our preemie children and their families continue to benefit from an in-house team of nurses who will continue to support the families as their babies transit home from the nursery back to home environment. Those who require longer term support continues to benefit from the support of Club Rainbow, a VWO which provides support for children with chronic medical or emotional needs.

What are the available options for parents to determine their chances of going into a preterm labour?
Early antenatal booking and consult with their obstetricians will allow them to better understand the care necessary. The attending doctors will also provide them with the red flags which help identify when pregnancy is not progressing optimally.

Prof Yeo Cheo Lian, Head and Senior Consultant Paediatrician with the Department of Neonatal and Developmental Medicine, is an accredited specialist in the care of newborns. She received her training in Neonatology and Developmental Paediatrics at The Mater Mother’s Hospital, Brisbane, Australia and The State Child Health and Development Centre, Perth, Australia. She is also presently appointed Clinical Professor with the Yong Loo Lin School of Medicine, National University of Singapore.

She sees newborns and children with health, developmental and behavioural problems.  Dr Yeo has wide experience in the care of preterm infants and follow-up management of infants. A strong advocate of family and patient centered care, Dr Yeo introduced the service of virtual visitation to the Newborn Intensive Care Unit in Singapore General Hospital.

For more related articles on childbirth and pregnancy, see:

What’s normal and what’s not in your newborn

What happens to your baby after delivery?

First week with your newborn