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<h2 style="color: #008080;">Pregnancy Stages of the Mother</h2>
Pregnancy is divided into 3 groups as follows
<ul>
<li>Group 1 Gestational age 38-40 weeks (Full Term) is considered full term. If the mother is healthy, she can deliver naturally.</li>
<li>Group 2 Gestational age 34-37 weeks (Post Term) is considered preterm and is the most common group. Babies in this group appear normal externally, but internal organs may have abnormalities. After birth, symptoms such as slightly rapid breathing, jaundice, poor sucking, and possibly the need for a ventilator may be observed, depending on the mother&#8217;s health. Babies born in this period weigh between 1,700-3,000 grams.</li>
<li>Group 3 Gestational age 28-34 weeks. Babies born in this group often have health problems because their internal organs are not fully developed. In the past, the obstetrics and gynecology association defined that if the gestational age was less than 28 weeks, birth was considered a miscarriage. However, with current medical technology advancements, preterm babies in this group have a higher chance of survival.</li>
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</ul>
<h2 style="color: #008080;">Health Problems of Preterm Infants</h2>
In cases where the gestational age is less than 34 weeks, babies born often have respiratory system problems because their lungs are not fully developed. Poor breathing affects other organs in the body as well.
<ul>
<li>RDS (Respiratory Distress Syndrome) occurs because the alveoli in the baby&#8217;s lungs lack surfactant, a substance that helps elasticity and reduces resistance. Normally, alveoli automatically expand and collapse during breathing. However, in preterm babies without prenatal preparation, the lungs lack surfactant, causing alveoli to collapse, making breathing difficult, causing fatigue and rapid breathing.</li>
<li>Heart valve disease or PDA (Patent Ductus Arteriosus) is a heart abnormality such as heart leakage or extra heart vessels. Normally, extra heart vessels can occur in all babies but close automatically around 37 weeks gestation or after birth when the baby cries because oxygen in the lungs activates the body&#8217;s mechanism to close these vessels automatically.</li>
<li>Infectious bowel disease or NEC (necrotizing enterocolitis) occurs because preterm babies have immature organs, including thin skin and intestines that have not yet produced digestive enzymes to digest food or milk independently. This increases the risk of bloating. Mothers should be cautious about the baby&#8217;s diet because the intestines are weak and prone to infection.</li>
<li>In very small babies, IVH (Intravascular Hemorrhage) is a condition where blood vessels are fragile, especially in the fontanel area, which is very delicate. If the baby cries loudly or experiences trauma, brain blood vessels may rupture, causing brain hemorrhage and potential future abnormalities.</li>
<li>Jaundice is common in preterm newborns. The severity and cause determine whether blood transfusion is needed. If phototherapy does not improve the condition, other complications may be present.</li>
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<h2 style="color: #008080;">How to Care for the Baby After Discharge from the Hospital</h2>
<ul>
<li>Once discharged, mothers must learn how to feed the baby themselves, including proper breastfeeding techniques, milk expression, and observing the baby&#8217;s feeding behavior.</li>
<li>Keep a record of the baby&#8217;s bowel movements to monitor the relationship between feeding and digestion.</li>
<li>Observe the baby&#8217;s breathing to prevent cyanosis or breathing difficulties.</li>
<li>The home environment should always be clean. Avoid setting the air conditioner too cold as the baby cannot adjust well. It is recommended to sleep in an air-conditioned room because of Thailand&#8217;s frequently changing weather. Set the air conditioner to 27 degrees Celsius and clean it regularly to prevent dust mites. Change bed sheets whenever they are soiled.</li>
<li>No pets should be kept in the house. Pets should be cared for elsewhere until the baby&#8217;s immune system is strong.</li>
<li>Avoid taking the baby to public places such as shopping malls because the baby&#8217;s immune system is still weak and can easily catch infections from others.</li>
<li>Pay attention to the baby&#8217;s nutrition to ensure complete nutrients and promote growth.</li>
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<h2 style="color: #008080;">Symptoms That Increase the Risk of Preterm Birth</h2>
<ul>
<li>Swelling and High Blood Pressure</li>
</ul>
This can occur in mothers with a history of hypertension, diabetes, or multiple pregnancies. It may be a sign of preeclampsia. Mothers with such histories during pregnancy should consult their doctors for close monitoring.
<ul>
<li>Bloody vaginal discharge</li>
</ul>
Bloody or brownish mucus or thick clots discharged from the vagina, if mild, can cause vaginal inflammation and cervicitis. If severe, it can cause placenta previa or placental abruption, uterine opening, leading to preterm labor and increasing the risk of fetal death.
<ul>
<li>Water breaking</li>
</ul>
Water breaking is the rupture or leakage of the amniotic sac, causing amniotic fluid to flow out. It usually occurs near labor but can sometimes lead to preterm birth due to strong uterine contractions or trauma. When the amniotic sac ruptures, infections can enter, causing fetal infection and potentially life-threatening complications.
 
<div style="text-align: right;">Dr. Urarom Panthumaphol</div>
<div style="text-align: right;">Neonatology and Perinatology Specialist</div>
<div style="text-align: right;">Child and Adolescent Health Center, Phyathai 2 Hospital</div>

A premature baby is a baby born before 37 weeks of gestation, whose internal organs are not yet fully developed. After birth, they require special care until they are strong enough to go home.

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