Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about prematurity. And if you want to follow along with written notes on this topic,

you can follow along at zero to finals.com slash prematurity or in the neonatology section of

the zero to finals Pediatrics book.

So let's get straight into it.

Prematurity is defined as birth before 37 weeks gestation.

Many successful and famous people were born prematurely, including Albert Einstein.

The more premature the baby, the worse the outcomes.

Attempting resuscitation in babies born under 500 grams

or before 24 weeks gestation should be carefully considered,

as the outcomes are likely to be very poor.

The World Health Organization classifies

prematurity as extremely preterm if the baby's under 28 weeks, very preterm at 28 to 32 weeks,

and moderate to late preterm at 32 to 37 weeks. There's a few associations with being born prematurely, and these are social deprivation,

smoking, alcohol, drug use, being overweight or underweight in pregnancy, maternal comorbidities,

twin pregnancies, and personal or family history of prematurity. Let's talk about the management before birth of premature babies.

There's a dramatic improvement in prognosis with each additional week of gestation,

particularly in very

premature babies. In women who have a history of preterm birth or an ultrasound scan

demonstrating a cervical length of 25mm or less before 24 weeks gestation, are given two options to try and delay the birth. The first is prophylactic

vaginal progesterone, and this involves putting a progesterone suppository in the vagina to

discourage labour. The other is prophylactic circlage, which involves putting a suture into the cervix to hold it closed.

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