Problems that are associated with a premature delivery

Babies born before 37 weeks of pregnancy may have multiple health problems because their ogans are not fully developed.  With a gestational age younger than 37 weeks, the newborn has increased risk for a birth weight less than 2,500 grams, jaundice at younger than 24 hours of age, sepsis and the need for resuscitation at birth.

Premature babies may become jaundiced because their liver may not be fully developed.  The immature liver may not be able to get rid of bilirubin.  In a premature baby, the threshold levels of concern about bilirubin levels are much lower because kernicterus occurs more often in premature infants than full-term infants.  The relationship between the incidence of kernicterus and both low birth weight and gestational age, has led many authors to conclude that premature infants constitute a population uniquely susceptible to bilirubin toxicity.

Low birth weight and abnormally short gestation are signficant risk factors for cerebral palsy.  The immaturity of low birth weight infants may contribute to the development of cerebral palsy.  About 25%-30% of cases of cerebral palsy are identified in children who were delivered preterm.

Specific brain regions are especially vulnerable to injury during certain periods, a phenomenon known as selective vulnerability.  Cerebral white matter is most susceptible before 32 weeks of gestation, whereas the basal ganglia (deep inner recesses of the brain) become most vulnerable to injury from hypoxic-ischemic insult and other insults in the last trimester of gestation.

In cases involving cerebral palsy arising from a traumatic birth (i.e., low Apgars, pH below 7.0, multi-organ dysfunction and seizures in the first 24-48 hours of life), the defense will attrribute the infant's cerebral palsy to his/her preterm delivery.  The defense will claim that the infant's vital organs were not fully developed at birth and therefore, the baby's brain damage was caused by some other than lack of oxygen just before birth (known as hypoxic ischemic encephalopathy or birth asphyxia).  This is the most common defense in cerebral palsy cases involving preterm infants.