Enlightenment About the Diagnosis of a Premature Infant

QUESTION: Can you offer us any enlightenment about the diagnosis of a
premature infant. Is it just their weight that counts, or do you have other
methods of judging? Is the cause for premature delivery understood?
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ANSWER: The strict definition of a premature infant is one that has been born
before 37 weeks of gestation or pregnancy. At one time any baby that weighed
less than 5.5 pounds was considered a premature birth, but a full term infant
of that weight would now be classified as small for gestational age (SGA). To
most experienced physicians, a premature infant just looks it. They are, of
course, smaller than usual, and their skin is shiny and pink, with the blood
vessels easily seen through the skin. They have little fat under their skin,
usually no hair, and the cartilage in their ears is missing. They are quiet
babies, not moving around as much as others, and their muscle tone is reduced.
In males the testicles may not have descended into the scrotum, which is
smooth and does not present the wrinkles of the mature baby. In females the
labia majora are not developed sufficiently to cover the labia minora which
lie beneath. The reasons for premature delivery are poorly understood,
without a clear cause. Premature deliveries are more common in women who have
had little or no prenatal care, who are in the lower socioeconomic classes,
where there is poor nutrition and poor education, and in unwed mothers. We
need to know much more as prematurity is the greatest cause of newborn deaths.