The Tiniest Miracles

Born too soon
Cushioned in amniotic fluid and connected to the umbilical cord's natural life-support system, a developing baby typically stays safe and snug in his mother's womb for 37 to 40 weeks. But nearly 12 percent of babies make their entrance into the world earlier -- sometimes well before the 37th week, the point at which an infant is considered full term. Not so long ago, many premature babies didn't survive outside the womb. Today, thanks to medical technology and treatments unheard of little more than a decade ago, even the smallest of preemies has a better chance to thrive. "Now we expect to lose very few babies born after 30 weeks and weighing only two pounds at birth, and the outlook for babies born at 28 and even 25 weeks is quite good," says Edward Bell, M.D., director of neonatology at Children's Hospital of Iowa, in Iowa City. Some hospitals are able to save babies weighing less than a pound and born as early as 22 weeks. Indeed, though the hurdles premature infants face are still daunting, the standards of care for them have never been higher, and their future looks brighter than ever.

Boost Your Baby's Health Before Birth
Even with the significant breakthroughs in neonatal care, prematurity is still a serious health threat -- it's the leading cause of death in the first month of life. And while doctors are now able to save many more preemies, extremely premature infants often face long-term health struggles. Fortunately, there are steps you can take to reduce your risk of premature delivery.

Step 1. Have a preconception checkup. If you're considering getting pregnant, see your doctor now to get screened for any health conditions that may threaten a full-term pregnancy. Known risk factors include diabetes, anemia, high blood pressure, hypothyroidism, obesity, STDs, and urinary-tract infections. Get these conditions under control before conceiving.

Step 2. Practice good prenatal care. Keep your ob-gyn appointments, eat right, and get regular exercise. If you've delivered early before or you're over age 35, it's especially important to be monitored closely. African-American women should be extra vigilant; for reasons experts don't understand, they have twice the rate of preemie births as Caucasians.

Step 3. Stay away from alcohol and cigarettes. Women who drink, smoke, or abuse drugs during pregnancy are more likely to deliver prematurely. Also, consult your doctor about any medications you're taking if you're pregnant or trying to conceive.

Step 4. De-stress. "Continual, low-grade stress can increase the risk of preterm labor," says Siobhan Dolan, M.D., assistant medical director for the March of Dimes. Yoga, meditation, and a daily walking regime can help you relax.

Step 5. Know the signs of preterm labor. If you notice frequent, regular contractions (ten minutes or less apart), vaginal bleeding or watery discharge, a low backache, or cramps that feel like your period, call your doctor immediately. Labor can sometimes be stopped or slowed with medication -- and even a few extra days in the womb can make a difference for your baby.

What does a preemie look like?
Babies born early -- especially those arriving before 28 weeks gestation—rarely have the appearance of full-term newborns. Here's what to expect with an early arrival.

Born at 24 to 28 weeks
(Extremely Premature)
The baby is skinny and tiny, and his head seems a bit too large for his body. Because the outermost layer of skin hasn't developed yet, he appears somewhat translucent and reddish pink. Soft, downy hair like peach fuzz covers his limbs and torso. This hair, which protected his skin in the womb, will be shed in six to eight weeks. If he's born before week 26, his eyes may stay closed for a few days after birth.

Born at 28 to 32 weeks
(Very Premature)
The baby has the body proportions of a typical newborn, but she doesn't yet have the muscle strength to bend her arms and legs into the classic fetal position. Instead, she extends her limbs out to the side while lying on her back. Because vision is the last of the sensory systems to mature, she has a hard time focusing on objects that aren't very close to her face.

Born at 32 to 37 weeks
(Premature)
The outer layer of the skin is almost completely developed at this stage, so the baby looks much like a full-term infant, only a bit smaller. He is strong enough to grasp a finger with his hand. Even though the baby has passed the threshold at which virtually all preemies survive, a stay in the neonatal intensive care unit (NICU) may still be necessary to ensure that his lungs, his body temperature, and all of his vital signs are stable.

A Shot to Prevent Early Deliveries
When women at high risk for preterm labor are given injections of a progesterone-type hormone beginning in the 16th week of pregnancy, their chances of premature delivery are reduced by one third, according to a recent study in the New England Journal of Medicine.