This Friday, 17th November, marks the World Prematurity Day, a date that aims to raise awareness of premature births, deaths and sequelae due to prematurity, promoted by the EFCNI - European Foundation for the Care of NewbornsThis is a platform created in April 2008 at European level, made up of parents and health professionals, with the aim of giving a voice to premature newborns and their families.
O premature birth is defined by the World Health Organisation (WHO) as birth before 37 completed weeks of gestation. It currently happens to more than 10% of the 130 million babies worldwide and 5 to 12% of the 5 million European babies." (EFCNI, 2019, Preterm Birth Factsheet).
The premature babies or pre-term can be categorised according to gestational age and birth weight, with neonatal morbidity being greater the more premature or lighter the baby is. Thus extreme" prematurity" includes babies under 28 weeks of gestation, the "great" prematurityThose who are born at less than 32 weeks are considered to be moderate" or "late" preterms" those born between 32-33 weeks and 34-36 weeks respectively. They are "extreme underweight" babies born weighing less than 1000 grams (g), from "very low weight" weighing less than 1500 g, and "low weight" between 1500-2500 g.
Physiotherapy intervention in prematurity
A vulnerability of these babies, due to the inherent characteristics of their prematurity and the immaturity of their organ systems, leads us to anticipate certain complications and requires close monitoring of their development, not only, but particularly in the case of extreme premature babies, due to the increased risk of sequelae associated with their condition. Physiotherapy intervention in this population has shown benefitsIt should be started early, even during hospitalisation in the NICU (Neonatal Intensive Care Unit).
The demands of early life and early experiences must be carefully observed by the person concerned. Physiotherapist, in order to better structure their approach, with the aim of promoting the baby's typical development, contributing to their neuromotor development and minimising or even avoiding serious sequelae.
A prematurity is the recognised cause of major sequelae such as cerebral palsy, cognitive impairment and moderate to severe neurosensory alterations. During hospitalisation, positioning and neuroprotective care are examples of physiotherapy intervention and play a fundamental role in preventing or minimising them. The respiratory condition is also affected in this population, with hyaline membrane disease (a typical disease of lung immaturity), and its evolution into bronchopulmonary dysplasia and chronic lung disease.
From neonatology to the home and from the home to the world. Physiotherapist is the health professional to have as a companion for the first months/years of life of premature babies and their families. It is therefore essential to establish an interdisciplinary follow-up plan after hospital discharge, which should include an assessment of the baby's neurological status, their motor, behavioural, cognitive and language development, so that early warning signs can be identified and timely intervention can be made to minimise or prevent sequelae.
To Physiotherapists also plays the role of educator, since the family's guidance is key to the success of their intervention. The many activities of everyday life are unique opportunities for the triad father-mother-baby can deepen relationships and enhance the baby's development. The Physiotherapists wants them to be better equipped parents, with tools to promote the harmonious development of their "little warriors", a term often used to describe this population and which refers to the resilience of premature babies.
