The number of newborns in my country keeps dropping every year, but due to many factors such as the aging of mothers, the rate of premature babies has not decreased but increased. The number of premature babies whose birth weight is less than 1,500 grams will increase from 1.86% of all newborns in 2017 to 2.11% in 2021. Facing a very low birth weight newborn, new parents are usually quite nervous and worried.
Dr. Colin Weiting, neonatologist of Chengda Hospital, said that with the advancement of technology, the minimum number of weeks of premature babies that can be cured in the world has dropped to 22 weeks. Chengda Hospital will celebrate a 20th pregnancy in January 2023 The three-week-old premature baby with a birth weight of only 351 grams was successfully discharged from the hospital. The child weighed more than 3,500 grams when he was discharged from the hospital. In the 2021 Taiwan Neonatal Medical Care Network Conference, Chengda Hospital achieved the lowest death rate and morbidity rate in the evaluation of various medical centers.
However, premature babies still face many challenges, including: respiratory problems, open ductus arteriosus, intraventricular hemorrhage, necrotizing enteritis, infection and many other conditions, which depend on the careful assessment and care of the obstetrics and neonatal team.
Dr. Lin Weiting pointed out that the first problem encountered by very low birth weight premature babies is breathing. When the baby is still in the mother’s womb, the mother helps to supply oxygen. , Thirty-five weeks later, they are relatively mature and can breathe on their own. Therefore, when it is found that there is a risk of premature birth, the obstetrician will first help the mother to administer steroids to help the fetus’s lungs mature; if the respiratory condition is not good following birth, it may be necessary to intubate and give the lung surfactant to help breathing; Intubation is required, and a respirator commonly known as a pig’s nose will be given to help breathe.
The next step may be the open ductus arteriosus. The lungs of the fetus have not yet started to function. The blood needs to pass through the open ductus arteriosus connecting the aorta and the pulmonary artery to supply other organs in the body. Full-term babies usually return to normal within one to one week following birth. Close the patent ductus arteriosus. However, due to problems such as hypoxia, inflammation, or immature vascular tissue, premature infants cannot close the open ductus arteriosus on their own, which may cause pulmonary edema, pulmonary hemorrhage, and shock symptoms, which require medical or surgical treatment.
In addition, premature infants are prone to intraventricular hemorrhage due to the large number of microvessels around the ventricles and their immature blood pressure regulation function. Therefore, intensive brain ultrasound is needed to track the children’s brain conditions.
Premature babies also need to pay special attention to dangerous and fatal necrotic enteritis between two weeks and two months following birth. The best way to prevent it is breastfeeding. It is recommended that mothers whose physical conditions permit express breast milk as soon as possible, or apply for breast milk donated by caring mothers from the Southern District Breast Milk Bank of Chengda Hospital. In addition, probiotics can also effectively prevent the occurrence of necrotic enteritis.
Dr. Lin Weiting pointed out that there are three conditions for premature babies to be discharged from the hospital, namely: leaving the incubator, the child can drink milk stably, and the family members can take care of them. According to past experience, the discharge time is regarding the original expected date of delivery of premature babies; and in a study published by the neonatology team of Chengda Hospital in 2022, statistics were collected from 2016 to 2018 for 3,283 babies in Taiwan. A premature baby with a birth weight of less than 1,500 grams was found to be discharged from the hospital regarding 2 to 3 weeks following the original expected date of delivery, and 25 to 27 weeks premature was discharged from the hospital regarding the original expected date of delivery. Premature babies over eight weeks will be discharged two to three weeks earlier than the original due date, and the exact time will still vary according to the condition of each newborn.
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