When the tiniest babies are born, the focus first is on survival and then on major disabilities. But some will face more subtle challenges that won't become clear until years after they've left the neonatal intensive care unit. Many children born at very low birth weights will have neurological problems, such as cognitive impairments, learning disabilities and behavioral problems. It is one of the hidden costs of preterm birth.
"Babies who are preterm, even into adulthood, continue to have issues," said Michael Uhing, medical director of neonatology at Children's Hospital of Wisconsin and a professor of pediatrics at the Medical College of Wisconsin. This is particularly true for infants born at 28 weeks or, using a broader measure, less than 1,500 grams, about 3.3 pounds. By comparison, a full-term pregnancy is 37 to 40 weeks and a normal birth weight is 2,500 to 4,000 grams, or 5.5 to 8.75 pounds. Complications from prematurity accounted for more than half of all infant deaths in Milwaukee, a city with one of the highest infant mortality rates in the nation. Most premature babies are born between 32 and 36 weeks of gestation, and most do just fine.
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