Infants born significantly before term usually require neonatal care until around the expected date of delivery. Following the introduction of surfactant coupled with the widespread use of antenatal corticosteroids in the mid-90s mortality rates for these infants fell significantly although in the smallest the risks of death remained high (Fig. 11.1). Rates in the twenty-first century remain similar to those shown. Mortality in extremely preterm babies can be significantly reduced if hypothermia is prevented at birth; this is only possible if the delivery room is maintained at an appropriate temperature. Most survivors do not suffer long-term disability, but in infants of less than 28 weeks gestation some 20% suffer neurodevelopmental impairment.
The stress on parents and family of having a baby who undergoes intensive care can be immense. They have to suffer prolonged uncertainly about the infant's survival as well as a loss of control over their baby's and their own
lives. Careful preparation of parents, with visits to the intensive care unit and meetings with unit staff may help, but the difficulties for families in this situation should not be underestimated.
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Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.