Your premature baby

• Premature babies are born before 37 weeks of pregnancy.
• We don't understand all the causes but are looking for answers.
• Learn about what to expect, now and in the year or so to come.

Some low birthweight babies are healthy, even though they’re small. But being low birthweight can cause serious health problems for some babies.

What causes a baby to be born with low birthweight?
There are two main reasons why a baby may be born with low birthweight:

1. Premature birth. This is birth before 37 completed weeks of pregnancy. About 7 of 10 low-birthweight babies are premature. The earlier a baby is born, the lower her birthweight may be. About 1 in 8 babies in the United States is born prematurely. Talk to your health provider about things you can do to help reduce your chances of having a premature baby.
2. Fetal growth restriction. This means a baby doesn’t gain the weight she should before birth. You may hear the terms “growth-restricted,” “small-for-gestational age” or “small-for-date” to describe these babies. They may have low birthweight simply because their parents are small. Others may have low birthweight because something slowed or stopped their growth in the womb. About 1 in 10 babies (10 percent) are growth-restricted. Your health care provider may think your baby isn’t growing normally if your uterus (womb) isn’t growing. He may use ultrasound and heart rate monitoring to check your baby’s growth. In some cases, a baby’s growth can be improved by treating health conditions in the mother, like high blood pressure.

Can a mother’s health condition lead to premature birth or fetal growth restricition?
Yes. These conditions in the mother may lead to premature birth and/or fetal growth restriction:

Preterm labor
This is labor that starts too soon, before 37 completed weeks of pregnancy.

Chronic health conditions
These are health conditions that last for a long time or that happen again and again over a long period of time. Chronic health conditions need treatment from a health care provider. Conditions that may lead to low birthweight include high blood pressure, diabetes and heart, lung and kidney problems.

Infections
Certain infections, especially infections in the uterus, may increase your chances of having a premature baby.

Problems with the placenta
The placenta grows in your uterus and supplies your baby with food and oxygen through the umbilical cord. Some problems in the placenta can reduce the flow of blood and nutrients to your baby, which can limit your baby’s growth. In some cases, a baby may need to be born early to prevent serious complications for both mom and baby.

Not gaining enough weight during pregnancy
Women who don’t gain enough weight during pregnancy are more likely to have a low-birthweight baby than women who gain the right amount of weight.

Smoking, drinking alcohol and using street drugs
Pregnant women who smoke cigarettes are nearly twice as likely to have a low-birthweight baby than women who don’t smoke. Smoking slows a baby’s growth and increases your chances of having a premature birth. Using alcohol and street drugs during pregnancy can slow your baby’s growth in the womb and can cause birth defects. Some drugs, like cocaine, may increase your chances of having premature birth.

Other conditions
You’re more likely than other women to have a low-birthweight baby if you:

• Have low income
• Don’t have a lot of education
• Are black
• Are younger than 17 or older than 35

Can a baby’s health condition lead to premature birth or fetal growth restricition?
Yes. These conditions in the baby may lead to premature birth and/or fetal growth restriction:

Birth defects
These are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. They may limit a baby’s development in the womb, which may lead to low birthweight. Babies with birth defects are more likely than babies without birth defects to be born prematurely.

Infections
Certain infections in the baby can slow growth in the womb and cause birth defects. These include cytomegalovirus, rubella, chickenpox and toxoplasmosis.

What medical problems can low birthweight cause for newborns?
Low-birthweight babies are more likely than babies with normal weight to have health problems as a newborn. Some need special care in a hospital’s newborn intensive care unit (NICU) to treat medical problems like:

• Respiratory distress syndrome (RDS). This breathing problem is common in babies born before 34 weeks of pregnancy. Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. Treatment with surfactant helps these babies breathe more easily. Babies with RDS also may need oxygen and other breathing help to make their lungs work.
• Bleeding in the brain (called intraventricular hemorrhage or IVH). Bleeding in the brain can affect low-birthweight premature babies, usually in the first 3 days of life. Brain bleeds usually are diagnosed with an ultrasound. Most brain bleeds are mild and fix themselves with no or few lasting problems. More severe bleeds can cause pressure on the brain that can cause fluid to build up in the brain. This can cause brain damage. To reduce the fluid, your baby may be treated with medicine. In some cases, a surgeon may insert a tube into the baby’s brain to drain the fluid.
• Patent ductus arteriosus (PDA). PDA is a common heart problem for premature babies. Before birth, a large artery called the ductus arteriosus lets the baby’s blood bypass his lungs. This artery usually closes after birth so that blood can travel to the baby’s lungs and pick up oxygen. When the artery doesn’t close properly, it can lead to heart failure. Providers use tests like ultrasound to check for PDA. Babies with PDA are treated with a drug that helps close the artery. If the drug doesn’t work, a baby may need surgery.
• Necrotizing enterocolitis (NEC). This is a problem in a baby’s intestines. The intestines are long tubes below the stomach that help digest food. NEC can develop up 2 to 3 weeks after birth. It can be dangerous for a baby. It can lead to feeding problems, swelling in the belly and other complications. Babies with NEC are treated with antibiotics and fed intravenously (through a vein) instead of by mouth while the intestine heals. In some cases, a baby may need surgery to remove damaged parts of intestine.
• Retinopathy of prematurity (ROP). ROP is condition that affects blood vessels in the eye. It mostly affects babies born before 32 weeks of pregnancy. Most cases heal themselves with little or no vision loss. Some babies need treatment, though, to prevent vision loss.

What medical problems can low birthweight cause later in life?
Babies born with low birthweight may be more likely than babies born at a normal weight to have certain medical conditions later in life. These include high blood pressure, diabetes and heart disease.

Talk to your baby’s health care provider about what you can do to help your baby be healthy. As your child grows, make sure she eats healthy food, stays active and goes to all her health care checkups. Getting regular checkups throughout childhood can help your provider spot health conditions that may cause problems as your baby grows older. These checkups also help make sure that your child gets all the vaccinations she needs to stay protected from certain harmful diseases.

What can you do to reduce your chances of having a low-birthweight baby?
Learn what you can do to get healthy before and during pregnancy to help reduce your risk of having a low-birthweight baby and improve your chances of having a healthy pregnancy and a healthy baby.

Last reviewed September 2012