Near-term
In 1963, when Jacqueline Kennedy gave birth to a baby boy five weeks early, his chances for survival were not good.
And in fact, Patrick Bouvier Kennedy, President Kennedy’s second son, lived only two days.
Had he been born today, the outlook would’ve been much different.
“It would certainly be shocking if that baby died from prematurity-related issues,” says Dr. Ron Shapiro, a neonatologist with the Pediatrix Medical Group of Spokane.
More and more so-called “near-term” or “late preterm” babies are being born between 34 and 36 weeks, studies show. Much attention is focused on the tiniest of preemies, but these bigger babies are often born with problems requiring medical intervention.
“They generally have very good outcomes,” Shapiro says of near-term babies. “They’re not at particularly high risk for long-term neurodevelopmental problems. But they’re still a medical burden.”
Between 1993 and 2003, the rate of infants born late preterm increased more than 22 percent in Washington and nearly 30 percent in Idaho, according to the March of Dimes. In Spokane, an informal hospital study found more than half of those babies required hospitalization after birth, Shapiro says.
And while no one is entirely sure what’s causing the trend, one thing remains clear:
When it comes to babies, closer to full-term is better.
“The goal is to keep the baby in utero as long as possible,” says Connie Mutton, a registered nurse in the neonatal intensive-care unit at Sacred Heart Medical Center.
Sometimes, though, babies have timetables all their own.
Tristin Olson-Roy had just been to her first birthing class when her water broke six weeks early. At that point, there wasn’t much to be done to keep Reece from coming into the world.
Olson-Roy received a steroid shot to help Reece’s lungs mature, and on July 12 he was born, weighing 5 pounds 10 ounces.”I wasn’t very worried really because I had read that after 30 weeks they have a 95 percent chance of survival,” says Olson-Roy, 33, who works as a health educator for Community Health Education Resources. “When he was born, he came out screaming and crying.”
His dad, Scott Roy, carried him to the NICU, where he stayed for a month.
He was too weak to nurse, so he was fed through a tube in his nose. He had jaundice. And he had episodes in which he would stop breathing.
But now Reece is a healthy 9-month-old, tipping the scales at 22 pounds.
“He had a little slow start, but then he was gaining half a pound a week,” his mom says.
Some believe the rising rate of Cesarean sections is contributing to the increase in late preterm births. Others say the increase in multiple births, sparked by growing use of fertility treatments, is the reason for more near-term babies. And others say medical technology has improved, helping those babies who would otherwise be born very early stay in the womb longer. “The single most important thing you can do in your pregnancy is to get prenatal care,” Mutton says. “They can follow you, and if you get into trouble, there’s a lot they can do to slow it down, to stop it, to monitor it.”
Babies born even a few weeks too early can have problems breathing and be at increased risk of infection. And they can have trouble coordinating the suck-swallow-breathe combination necessary for eating.
“They choke a lot,” and they cannot be able to cough it up,” Mutton says, adding that they have a hard time coughing up milk. “It’s scary when you have a new baby.”
Olson-Roy has no idea why she went into early labor. She’s a triathlete and had good prenatal care. Her placenta was tested for signs of infection, but nothing turned up.
“They say sometimes they just don’t know,” she says.
“It was a very scary thing, but I learned the hospitals now have great things to help babies.”