Preterm Birth

When is a baby considered “preterm” or “extremely preterm?”

A normal pregnancy with one baby lasts about 40 weeks. Babies born before 37 completed weeks of pregnancy are called “preterm” or “premature.” Babies born before 28 completed weeks of pregnancy are considered extremely preterm. The earlier a baby is born, the less likely he or she is to survive. Those who do survive often have serious, sometimes long-term health problems and disabilities.

A premature birth is a birth that takes place more than three weeks before the baby's estimated due date. In other words, a premature birth is one that occurs before the start of the 37th week of pregnancy.

Proluton Depot 500 mg (Hydroxyprogesterone), Hydroxyprogesterone is used to reduce risk of preterm birth (delivery in <37 weeks of pregnancy) in women pregnant with one baby (singleton pregnancy) and who have delivered a premature baby in the past.

Depending on how early a baby is born, he or she may be:

• Late preterm, born between 34 and 36 completed weeks of pregnancy
• Moderately preterm, born between 32 and 34 weeks of pregnancy
• Very preterm, born at less than 32 weeks of pregnancy
• Extremely preterm, born at or before 25 weeks of pregnancy

What is gestational age?

Gestational age is the “age” of the pregnancy. It often is counted in weeks and days. For example, “24 and 2/7 weeks of pregnancy” refers to 24 completed weeks and the next 2 days of pregnancy.

Symptoms

Your baby may have very mild symptoms of premature birth, or may have more-obvious complications.

Some signs of prematurity include the following:

• Small size, with a disproportionately large head
• Sharper looking, less rounded features than a full-term baby's features, due to a lack of fat stores
• Fine hair (lanugo) covering much of the body
• Low body temperature, especially immediately after birth in the delivery room, due to a lack of stored body fat
• Labored breathing or respiratory distress
• Lack of reflexes for sucking and swallowing, leading to feeding difficulties

What are the health outcomes for extremely preterm babies?

Medical advances have helped some preterm babies survive and overcome health challenges. However, the chances that a baby born extremely early will survive without disability are still small. With very rare exceptions, babies born before 23 weeks of pregnancy do not survive. Although survival rates increase for babies born between 23 weeks and 25 weeks of pregnancy, most survivors face serious, often lifelong disabilities. As gestational age increases, the outlook for preterm babies improves.

If my baby is born extremely preterm, will he or she need resuscitation?

Extremely preterm infants will not survive without resuscitation. Often this means helping the baby breathe by inserting a tube into his or her airway. Steps may be taken to start the baby’s heart. Even with resuscitation efforts, some babies will not survive. Those who do may have severe disabilities. Babies born before 23 weeks of pregnancy typically do not survive even with resuscitation. In some cases, after discussion with the health care team, a family may decide that resuscitation is not the best option for their baby. In situations like this, medical care will focus on keeping the baby warm, comfortable and free from pain.

Special care

If you deliver a preterm baby, your baby will likely need a longer hospital stay in a special nursery unit at the hospital. Depending on how much care your baby requires, he or she may be admitted to an intermediate care nursery or the neonatal intensive care unit (NICU). Doctors and a specialized team with training in taking care of preterm babies will be available to help care for your baby. Don't hesitate to ask questions.

Your baby may need extra help feeding, and adapting immediately after delivery. Your health care team can help you understand what is needed and what your baby's care plan will be.

The solution of preterm birth 

More than three quarters of premature babies can be saved with feasible, cost-effective care, such as essential care during child birth and in the postnatal period for every mother and baby, provision of antenatal steroid injections (given to pregnant women at risk of preterm labour and under set criteria to strengthen the babies’ lungs), kangaroo mother care (the baby is carried by the mother with skin-to-skin contact and frequent breastfeeding) and antibiotics to treat newborn infections. For example, continuity of midwifery-led care in settings where there are effective midwifery services has been shown to reduce the risk of prematurity by around 24%.

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The definition of a generic drug, from the U.S. Food and Drug Administration (FDA), is a product that is identical, or bioequivalent, to a brand name drug in dosage form, safety, and strength, route of administration, quality, performance characteristics and intended use. Generic drugs are chemically identical to their branded counterparts, but they are typically sold at substantially lower prices. According to the Congressional Budget Office, generic drugs save consumers an estimated $8 to $10 billion a year at retail pharmacies. Billions more are saved when hospitals use generics.

Generic drugs must pass rigorous controls, just like the innovative drug originally created. There is no loss in quality, strength, purity and stability of the generic drug. However, patients may have the perception that a generic drug is not as effective as the original brand name.

Advantages

If you've had a prescription filled recently, there's a good chance you're taking a generic drug. Almost 70% of prescription drugs sold is generics. That option helps save patients and hospitals billions of dollars every year.

It's estimated that you could save at least two-thirds of your drug costs if you use generic drugs.

According to the FDA, generic drugs can be trusted to have the same quality as brand-name drugs -- but at a cheaper price. That's important to know because no one wants to skimp on health, even if it means saving money.

For the FDA to approve a generic drug

It must be the same as the brand-name product in:

• Active ingredient
• Strength
• Use and effect
• How you take it (for example as a pill, inhaler, or liquid)
• Ability to reach the required level in the bloodstream at the right time and to the same extent
• Testing standards

Did you know that 80 percent of all prescriptions filled in the United States are for generic drugs? In fact, Americans save approximately $158 billion each year by not purchasing name-brand medications.

However, some people are still wary of buying generic drugs instead of relying on the name brand. This is because there are a lot of myths flying around about the nature of generic medication.

Why it’s safe?

Generic drug makers are required to follow the same rigorous standards when it comes to effectiveness as any other drug maker. This is done by measuring how much of the drug is absorbed into the bloodstream. It must be the same for both generic and brand-name companies.

It’s cheaper, so it must not work as well.

The reason why generic drugs are so cheap is because they don’t have to invest in the initial research. After the brand-name’s patent has expired, other drug makers are able to use their research and recreate it for a much lower cost.

Generic drugs are made under unsafe or unsanitary conditions

Most generic drugs are made in the same facilities that brand-name drugs are made.