Babies born before the due date that is, those born between twenty four and thirty seven weeks of gestation are termed as born premature. Prematurity makes these babies susceptible and they need special care for their continued existence. Eager to step out of their mothers’ womb little do these tiny champions realize that survival would be so demanding.

A premature delivery is generally a life and death decision. A sizeable number of factors determine prematurity. It could be the failure to arrest an early labour or an induced early labour due to the health of the mother.

Adverse intra uterine conditions, placental malfunction, multiple pregnancies, premature rupture of membranes, inadequate antenatal care, age of the mother, lifestyle factors and previous gynaecological history are some of the causes of a preterm delivery.

Premature babies are, as a mater of fact unprepared for the world and exhibit some common characteristics which include fragility with low body weight, red see through skin, little or no body fat, sparse scalp hair, feeble cry and undersized genitals

Since the gestational age, birth weight and overall maturity of a premature baby is less than that in a standard term of pregnancy, prematurity brings about some common problems.

• Difficulty in breathing.
• Difficulty in feeding and poor digestion.
• Increased vulnerability to infection.
• Low heart rate.
• Erratic blood pressure.
• Anemia
• Immature kidney function.
• Congenital defects.
• Inability to maintain body temperature.
• Susceptibility to brain haemorrhage.

Premature babies need special care which is often given in Neonatal Intensive Care Unit (NICU). In the NICU preterm babies are kept in insulators and a comprehensive and sophisticated monitoring of all their body parameters is done constantly.

Kangaroo care is encouraged to reduce mortality rate. Once a pre term baby catches up with his growth and development he is discharged, but he still needs that special care until the due date of pregnancy

Prematurity may have repercussions beyond infancy and into childhood. In fact, some premature babies have lasting connotations that have a bearing on the rest of their lives - bodily, psychologically or rationally. Special attention needs to be paid to their school and pre-school years. Parents’ participation in the care of a premature baby is a must and is very favourable to the child’s health.

To some extent (15%), a woman who has had a preterm birth has the chance of having it again in her next pregnancy as well, but this is not a surety.

Premature babies also need to be protected by immunizations, based on the child’s chronological age from birth. An immature immune system should not be considered as a deterrent to the immunization process.

Although the survival rate of premature infants has gone very high over the years due to advancement in the field of medicine, still the safest place for a child to develop is in the uterus, the way nature wanted it to.

If truth be told, the hard to believe survival rates that have been achieved for very premature babies have stimulated a discussion about the upper limit for termination of pregnancy.

But despite all odds the little heroes continue their struggle in this challenging world beyond the womb.