These babies are born too soon, but they are not born to die. Their deaths are
To begin with, the word “premature” in the 19th century was not equivalent to what we mean by
“preterm.” Medical writers instead grouped together all tiny newborns under the category of
and weak infants,” or congenital “weaklings” for short. Such babies were thought suffering from
a lack of energy or vitality.
The first invention of a medical technology directed at premature infants, was an incubator. Its
invention was associated with the French obstetrician Stephane Tarnier, who in the 1870s
developed a means to warm the numerous premature infants. It was a device for the care of
infants similar to the chicken incubator at the Paris zoo. Tarnier’s first incubator housed several
infants who were warmed over a hotwater reservoir attached to an external heating source.
The active treatment of very ill or premature infants was not generally undertaken by doctors
until the 20th century. The physicians who specialize in the care of very sick or premature babies
are known as neonatologists.
Neonatologists treat infants with a wide variety of complex medical disorders. Infants born with
infections or to drugaddicted mothers are treated in a neonatal intensive care unit (NICU), if the
medical situation is severe or possibly in a special care nursery for infants who are less severely
ill. Conjoined twins, infants with heart conditions and other medical disorders such as genetic
disorders, breathing disorders, metabolic disorders and feeding disorders need neonatal care.
Sometimes, neonatologists work with surgeons who specialize in surgery on the very young
The majority of infants cared for by neonatologists are preterm. A premature birth occurs when a
baby is born before 37 weeks of pregnancy (full term is 40 weeks). The causes of premature
births are not fully known. The risk of preterm delivery varies considerably. Some women have
several times the risk of others. For example, women with a previous preterm delivery have two
to three times the usual risk of having a preterm infant in a subsequent pregnancy. Some risk
factors can be controlled (such as alcohol, cigarette smoking and illicit drug use), but other
factors, such as age, multiple gestation, and uterine abnormalities, can’t be controlled. Most
preterm deliveries occur spontaneously but are sometimes the result of a doctor`s decision due to
health concerns for the baby or mother.
Premature Birth Survival Rates
Babies born at 23 weeks
Chance of Survival
9095 % 3233 weeks
A variety of factors can affect the growth of children born prematurely. Growth is determined by
a combination of heredity and nutrition, and can be influenced greatly by prenatal and postnatal
Infants as small as 450 grams and as early as 22 weeks gestation have a small but calculable
chance of survival. Advances in neonatology have made it possible for the survival of infants
weighing at least 2 pounds (1000 grams) and at 27 weeks gestation up to 95% of the time.
In developed countries premature infants are usually cared for in a neonatal intensive care unit
(NICU). In the NICU, premature babies are kept under radiant warmers or in incubators, also
called isolettes or couveuse, which are bassinets (A bassinet, bassinette, or cradle is a bed
specifically for babies from birth to about four months, and small enough to provide a "cocoon"
that small babies find comforting.) enclosed in plastic with climate control equipment designed
to keep them warm and limit their exposure to germs. Modern neonatal intensive care involves
sophisticated measurement of temperature, respiration, cardiac function, oxygenation, and brain
activity. Treatments may include fluids and nutrition through intravenous catheters, oxygen
supplementation, mechanical ventilation support, and medications.
Although premature babies usually need to be treated in a neonatal intensive care unit, parents
play a crucial role in the healthy development of their babies. In developing countries where
advanced equipment and even electricity may not be available or reliable, simple measures such
as kangaroo care (skin to skin warming), encouraging breastfeeding can significantly reduce
preterm morbidity and mortality. The technique Kangaroo Mother Care works well for both
mothers and babies. Using this technique, the tiny infant is held skintoskin on the mother's
chest. This keeps the baby warm and facilitates breastfeeding. Studies show that the mortality
rate for babies who benefit from Kangaroo Mother Care can be the same or better than that for
babies in incubators. Prophylactic treatments and basic infection control measures are also used
to care for preterm infants.
"People think that preterm babies need intensive, hightech care, but we have simple methods
that really work and would save hundreds of thousands of lives," says Joy Lawn, a neonatal
Preterm birth is the leading cause of neonatal mortality and now the number two cause of child
mortality globally. Preterm birth is the world's largest killer of newborn babies, causing more
than 1 million deaths each year, yet 75 percent could be saved without expensive, high
technology care. World Prematurity Day, November 17 2013, is a global movement to raise
awareness of the deaths and disabilities due to prematurity and the simple, proven, costeffective
measures that could prevent them.
Hundreds of associations, societies, professionals, private sector organizations and individuals
come together with events and activities in nearly 50 countries, bringing attention to the global
challenge of premature birth.