Premature by 2 to 3 weeks may raise risk for health issues: Study

By Dr. Ananya Mandal, MDMar 4 2012

A new study shows that babies born even just a few weeks early are more likely to suffer from poor health, including asthma.

Premature babies have always thought to be at risk of health issues but till now the health prospects of babies born two to three weeks premature were considered similar to those who were born at full-term.

But the latest findings demonstrate that such babies, born at 37 to 38 weeks – and of whom there are about 125,000 a year in England alone – are in fact at higher risk of health problems than those born later.

For the study 14,000 British children were followed. Researchers compared data for moderate/late pre-term babies born at 32 to 36 weeks and for those regarded as early term, 37 to 38 weeks. The babies were assessed when they were aged nine months and again when they were aged three and five and the results were reported in the British Medical Journal.

Results showed that the earlier a baby was born, the more likely it was to suffer long-standing illnesses. They were also admitted more frequently to hospital in the first nine months of life, most commonly for respiratory and gastrointestinal disorders.

In addition even babies born at 37 to 38 weeks had poorer health than those born later. For example, they were 10 per cent more likely to suffer from a long-standing illness, or asthma and wheezing, than those born at 39 to 41 weeks. They were also 40 per cent more likely to have been prescribed an asthma inhaler at the age of five than those born at 39 to 41 weeks.

The researchers from the University of Leicester and the National Perinatal Epidemiology Unit at the University of Oxford, said, “Our results challenge perceptions about outcomes for babies born during part of the period of gestation that has traditionally been regarded as term (37 to 38 weeks).” The experts pointed out that research and resources were frequently directed towards very premature babies, who have the highest risk of death and health problems. But they argue that their numbers are relatively small – about 8,000 are born each year in England – and are far outnumbered by more mature pre-term babies, born at 32 to 36 weeks.

Dr Elaine Boyle, from the University of Leicester, said, “We've found that it's no longer appropriate, as we have done previously, to think of babies as either being born at term or premature. What we've found is that there is a gradient of increasing health risk with increasing prematurity but this risk stretches right up until the time at which a baby should be born.”

However, she cautioned, “There's more work to do on whether it's feasible or even desirable to follow up all these babies. We don't want to medicalise a lot of normal babies and worry their parents sick.”

Andy Cole, chief executive of the special care baby charity Bliss, welcomed the research. He said, “This study highlights the need for the very best care to be given to all babies born preterm no matter at what gestation, and not just those admitted to intensive care. Babies born early are at a higher risk of conditions such as asthma in childhood and should be given regular health check-ups to ensure they remain healthy. While the study indicates a slight increase in the risk of asthma and wheezing in children born a few weeks early, we would not suggest this is a cause for concern.”

Professor Andy Shennan, consultant obstetrician for pregnancy research charity,  Tommy’s said, “It is increasingly appreciated that babies born even a few weeks early can have long term health and behavioral issues. Most pre-term related problems actually come from these later pre-term births, as although less serious, they are far more common than very early births.”

Leanne Metcalf, assistant director of research at Asthma UK, said, “This is not the first piece of research to indicate that every week spent in the womb is important for a baby in order to reduce its risk of developing asthma in childhood. The advantage of this  study, however, is its scale in terms of the number of  children whose asthma development compared to their gestational age has been measured, and the fact that it has looked at babies who are born just a few weeks prematurely.” She added that there are a number of things pregnant women can do to reduce the risk of giving birth prematurely, including maintaining a healthy weight, staying active and avoiding stress, smoking and infections.