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Babies Born at 35 Weeks: Causes, Risk Factors, and Management

Called “late preterm infants,” babies born at 35 weeks still require proper care and management. Read on to learn more about the possible causes and risk factors of premature birth and how you can manage a baby born at 35 weeks.

According to estimates, 15 million infants (more than 1 in 10) are born prematurely every year. 

The delivery of a baby before 37 weeks of gestation is known as preterm birth.

Based on gestational age, preterm birth is divided into subcategories:

  • Extremely preterm (baby is born before 28 weeks of gestation)
  • Very preterm (baby is born between 28 and 32 weeks of gestation)
  • Moderate to late preterm (baby is born between 32 and 37 weeks of gestation)

The cause of preterm birth is usually not a single factor but a wide variety of conditions, which may affect the pregnant woman and/or the fetus. Some of the common causes that can lead to preterm birth include infections, multiple pregnancies, stress, and chronic medical conditions such as high blood pressure and diabetes. However, in many cases, doctors can’t find a cause for preterm birth. Genetics may also play a role in preterm birth.

The birth weight of a premature baby is lower in comparison to a full-term baby. The weight of many babies born at 35 weeks is less than 5 pounds, 8 ounces.

Some of the common signs that come along with prematurity include:

  • Body hair (referred to as lanugo)
  • Abnormal patterns of breathing (babies may have irregular, shallow pauses in their breathing known as apnea)
  • Less body fat
  • Enlarged clitoris (in female babies)
  • Reduced muscle tone and activity in comparison to full-term babies
  • Feeding problems as the infant may have trouble coordinating breathing and swallowing or sucking
  • Small scrotum that is smooth and without ridges along with undescended testicles (in male babies)
  • Flexible and soft ear cartilage
  • Smooth, shiny, and thin skin, which often appears transparent (veins may be visible under the skin)

Specifically, late preterm babies or babies who are born at 35 weeks have an increased risk for some medical conditions including:

  • Respiratory distress (labored breathing)
  • Low levels of blood sugar (hypoglycemia)
  • Feeding difficulties
  • Apnea
  • Yellowing of the skin and whites of their eyes 
  • Seizures
  • Hypothermia (abnormally low temperature of the body)
  • An increased rate of readmission to the hospital after initial discharge

Additionally, babies born at 35 weeks (or late preterm babies) are more prone to develop disorders affecting the lungs during their childhood and teenage years and learning difficulties along with minor and subtle cognitive deficits. As adults, babies born at 35 weeks may be more likely to develop diabetes and/or high blood pressure.

A baby born at 35 weeks of gestation needs close monitoring for the first 24 hours after delivery. Your health care team will make sure to keep the mother and the baby together as much as possible. To help with your baby’s psychological development, doctors will encourage lots of skin-to-skin contact.

If the doctors decide that a premature baby born at 35 weeks needs care in the neonatal intensive care unit, they may be placed in an incubator (a heated box that controls the temperature of the air). They track the breathing, blood oxygen levels, and heart rate with monitoring machines.

The organs of a baby born at 35 weeks aren’t fully developed. The baby may be placed in a nursery for special care for many weeks or months until their organs have developed enough to keep them alive without medical support.

The doctors may place a soft, small feeding tube that runs from the baby’s mouth or nose into their stomach so that they can get the nutrition they need.

If the preterm baby develops breathing problems:

  • The doctors may place a tube in their windpipe and use a machine known as a ventilator to help them breathe.
  • Some infants with less severe breathing problems get continuous positive airway pressure (CPAP) or extra oxygen through small tubes in their nose. 
  • The doctors may give the baby extra oxygen by using a ventilator, nasal prongs, CPAP, or an oxygen hood.

A baby born at 35 weeks needs special care in a nursery until they can feed by mouth, breathe without support, and maintain their body weight and temperature.

If a preterm baby is kept in a nursery, doctors will prepare the mother to return home without taking their baby with them. The doctors will monitor the mother closely for any signs and symptoms of post-traumatic stress disorder and/or postpartum depression.

Your pediatrician or family doctor should see your baby within one to two days after leaving the hospital. They will make sure your baby is stable and developing well, and determine if any additional treatment is needed.

Here are some of the things pregnant women can do during and before pregnancy to prevent and reduce the risk of preterm birth:

  • Talk to a doctor about planning a healthy diet.
  • Talk to a doctor about the importance of stopping smoking.
  • Improve your health before you get pregnant to reduce the risk of chronic medical illnesses such as obesity, diabetes, etc.
  • Wait longer between multiple pregnancies. Getting pregnant again less than six months after the previous one increases the risk of having a late preterm delivery.
  • Visit your doctor for regular fetal measurements with the help of ultrasound. This helps determine gestational age and detect multiple pregnancies.
  • Your doctors should do a screening before the 34th week of gestation if you have a history of preterm delivery. If the doctor sees that your cervix is less than 25 millimeters long, they may suggest a procedure called cervical stitch.
  • Doctors may prescribe progesterone to treat women who have a history of preterm delivery.

When preterm delivery can’t be prevented, the doctor will take some steps to ensure the health of babies born at 35 weeks:

  • If there’s no evidence of infection and preterm birth is imminent, the doctor may give the mother steroid injections.
  • Antibiotic prophylactic therapy can help protect the baby when the mother’s water breaks before labor begins.

Late preterm babies (babies who are born between 34 and 37 weeks of gestation) are less mature and developed than full-term babies. Hence, babies born at 35 weeks are at a higher risk of developing complications than full-term babies. One of the best ways to prevent preterm birth is with high-quality prenatal care.

https://www.who.int/news-room/fact-sheets/detail/preterm-birth

https://www.uptodate.com/contents/late-preterm-infants

https://pediatrics.aappublications.org/content/144/5/e20192760

https://medlineplus.gov/ency/article/001562.htm

http://www.nationalperinatal.org/resources/LatePretermGuidelinesNPA.pdf

https://apps.who.int/iris/bitstream/handle/10665/183037/9789241508988_eng.pdf?sequence=1

https://pediatrics.aappublications.org/content/pediatrics/120/6/1390.full.pdf

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