Provider Quality

November is Prematurity Awareness Month, a time to highlight preterm birth and the health issues it poses for infants and mothers.

What defines prematurity?

A term pregnancy usually lasts for 40 weeks. A premature baby is an infant that is born before 37 weeks gestation. A 2024 March of Dimes report shows that one in 10 babies are born premature every year. Often, people do not understand that premature babies are not just smaller in size, they can have many issues that range from immature lungs to developmental delays. These babies require a longer stay and more intensive care as they grow and develop outside of the womb. These preterm babies need to spend time in a hospital’s Neonatal Intensive Care Unit, also called a NICU. Almost all premature babies will stay in the NICU until they reach their original due date or 40 weeks. Some may go home sooner, and some will be there longer. It depends on how early they were born and what conditions have arisen because of their prematurity.

Babies are categorized into prematurity groups. You might hear a provider use these terms to describe a premature baby’s birth:

• Extremely preterm: Your baby is born at or before 25 weeks of pregnancy. These babies might be called “micro-preemies.”
• Very preterm: Your baby is born at less than 32 weeks of pregnancy, but after 25 weeks.
• Moderately preterm: Your baby is born between 32 and 34 weeks of pregnancy.
• Late preterm: Your baby is born between 34 and 36 weeks of pregnancy.

The earlier in pregnancy a baby is born, the more likely the baby will have health problems. Some common problems are breathing issues, digestive issues, or difficulty in maintaining body temperature. These babies are at high risk for bleeding in the brain, chronic lung disease, and retinopathy of prematurity.

What causes a baby to be born prematurely?

No one knows exactly why some babies are born prematurely. There are some issues that can increase risk. These include:

• Multiple babies. Twins, triplets, or more are often a reason that a woman delivers early.
• Waiting less than 6 months between pregnancies.
• Receiving treatments to help one become pregnant such as in-vitro fertilization (IVF).
• Prior history of more than one miscarriage or abortion.
• Previously having a preterm delivery.
• Problems with the uterus, cervix, or placenta.
• Maternal infection.
• Smoking, drug use, or alcohol use.
• Having high blood pressure or diabetes.
• Injury or trauma while pregnant.
• Being underweight or overweight.
• Becoming pregnant before the age of 17 or after the age of 35.

Anyone can have a premature delivery. Black or Indigenous people in the U.S. have more frequent preterm births than White mothers.

Can I prevent preterm delivery?

If you are at increased risk of preterm birth, talk with your provider about things you can do to lower that risk. These include:

• Taking progesterone supplements. Progesterone is a hormone that plays a role in pregnancy.
• Cervical cerclage. This surgery is performed during pregnancy. During this procedure, the cervix is stitched closed with a strong suture. This may give the uterus extra support. The suture is removed when it is time to have the baby.

The goal of every pregnancy is to have a full-term, healthy baby. Here at Fidelis Care, we help members accomplish this goal by referring all pregnant members to the BabyCare team. BabyCare is a free, voluntary program for all eligible members to assist throughout their pregnancy and postpartum. The program is tailored to each member’s specific needs. Fidelis Care has a specially trained team of associates, nurses, social workers, and mental health specialists available to provide phone support and additional resources as needed throughout pregnancy and after delivery.

If a member delivers prematurely, the BabyCare team also offers NICU case management. These specialized nurses follow the member and their baby throughout the NICU stay and for three months after discharge.

Preterm birth can lead to long-term challenges for some babies, including intellectual and developmental disabilities. If we can assist our pregnant members in having healthy, full-term babies and reduce the risk of delivering early, then hopefully we can reduce potential complications.

Christine Goodwin, RN, is a Senior Care Manager on the Fidelis Care BabyCare team. Her 24-year career in nursing includes work in the surgical intensive care unit, newborn nursery, and Level III NICU. She has served as a Fidelis Care NICU Case Manager for five years.

Additional Resources:

Fidelis Care BabyCare Program

Mayo Clinic Premature Birth Facts

March of Dimes Preterm Baby Fact Sheet