Tiny heroes

Premature babies: Tiny heroes of life

Physical contact with the parents is particularly important for premature babies.

(Bild: stock.adobe.com/Tobilander)

The little ones were the big topic at the Congress of European Pediatric Societies: experts discussed how to increase the chances of survival of premature babies and avoid complications. Parents should also be better involved in intensive medical care.

Every tenth child worldwide is born prematurely. In addition, the first few days are the most dangerous of the baby's life. Neonatology therefore plays a central role in pediatrics.

At the 10th Congress of European Pediatric Societies in Vienna, experts recently discussed what measures are needed to increase the chances of survival of premature babies, how complications can be avoided and how parents can be involved in intensive medical care. We report:

When is a baby considered premature?
"The limit of viability is the point at which a newborn has a real possibility of survival outside the mother's body. In highly developed countries, the chances of survival are 50% from 22 weeks of pregnancy, 70-80% from 23 weeks and even over 90% from 28 weeks," explains Prof. Dr. Sven Matthias Wellmann, neonatologist from Regensburg, Germany, and Council member of the European Society for Paediatric Research (note: the normal duration of pregnancy is 40 weeks).

If the baby is born at less than 28 weeks' gestation, this is referred to as "extreme prematurity". The most common complications include brain and lung bleeding, intestinal problems and serious infections.

Centralization of services in a few clinics
"Especially in borderline medicine such as neonatal intensive care, it is extremely important to centralize services in a few clinics with the appropriate expertise, experience and case numbers in order to give even the tiniest premature babies a chance of a healthy life.

Nowadays, children born from week 22 of pregnancy can survive.

(Bild: stock.adobe.com/ondrooo)

In other words, expectant mothers who are at risk of giving birth at a very early week of pregnancy come to us at the Perinatal Center at Vienna General Hospital even before they give birth, so that we can ensure the best possible preparation for the birth and care of the newborn afterwards," explains Prof. Dr. Angelika Berger, MBA, Head of the Division of Neonatology, Paediatric Intensive Care Medicine and Neuropaediatrics at MedUni Vienna. The Perinatal Center at Vienna General Hospital is the largest in Austria and one of the largest in the German-speaking world.

Research at Vienna General Hospital
"We conduct a great deal of clinical research, take part in international studies and also carry out our own academic studies in order to continuously investigate new and even better treatment options. For example, we are currently working on prognostic markers for the neurological development of premature babies, the optimization of ventilation techniques and the prevention of infections in intensive care units for premature babies," says the expert, giving a brief insight into her work.

Skin-to-skin contact has a neuroprotective effect. In addition, parents and newborns calm down and the experience of stress is reduced.

Prof. Dr. Sven Matthias Wellmann, Neonatologe

Lung maturity injections: Use even before birth
In highly developed countries, the following applies: if the "birth" is imminent before the 34th week of pregnancy, the mommy-to-be is given lung maturity injections - preferably from two days beforehand.

"These contain the active ingredient cortisone and give the unborn child the signal to produce the substance surfactant, which regulates the development of the alveoli and ensures that the baby can breathe better after birth. After delivery, we also support the babies with a breathing mask as a precautionary measure," reports Prof. Wellmann.

This is an attempt to prevent possible collapse of the lungs and impending complications (e.g. respiratory distress syndrome or cerebral hemorrhage). Artificially produced surfactant is also often injected after birth. A multi-professional team of doctors, nursing staff - and parents - is required to care for the youngest babies. Whereas around 20 years ago, mom and dad were still seen as visitors to their children in the intensive care unit, they now have to be seen as part of the premature baby.

"Parents and child belong together psychologically. Skin-to-skin contact has a significant neuroprotective effect [note: protection of nerve and brain cells from damage]. Parents and newborns calm down and the experience of stress decreases. This promotes the baby's development and is particularly important for the maturation of the brain," reports Prof. Wellmann.

Innovative program at MedUni Vienna
In June 2024, MedUni Vienna's Department of Neonatology became the first center in Europe to launch the SENSE program, which enables parents to provide their premature babies in a neonatal intensive care unit with positive, development-promoting experiences and thus optimally support their development from day 1. To do this, they offer specific stimuli (such as tactile and auditory).

"Initial studies have already shown a positive influence on neurological development. The program also demonstrably promotes parenting skills and the bond between parents and child," says Prof. Berger, pleased with the initial successes. In addition, young parents receive psychological and physiotherapeutic support and training at all specialized centers. This prepares them for discharge from hospital and for dealing with possible complications of premature birth.