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Mütterliche Risiken – kindliches Wachstum

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Both obstetrics and neonatology, together perinatology, are intensively concerned with the problem of preterm birth. Therapy determines everyday clinical practice; the future belongs to prevention. Being born too early often also means being a “growth-restricted newborn”; the birth weight is too low for the respective duration of pregnancy. Preterm infants with very low birth weight represent an additional challenge for paediatricians. These small patients in particular are at risk and require extensive intensive care measures, including rehabilitation in infancy and childhood. The risks to health and development resulting from the immaturity of preterm infants call for extensive medical and socio-political action. The burden of physical and psychological impairments plays a major role for the infants themselves and their families, but also for the healthcare system, which experiences an enormous increase in costs through these cases: a tenfold increase in inpatient costs compared with term infants and lifelong follow-up costs, so-called life-time costs.

The rate of preterm infants born < 36 weeks of gestation (WG) has remained unchanged for about 30 years, ranging between 5 % and 7 %. At perinatal centres, proportions of 10 % – 15 % are reached. The number of very early preterm births (< 30 WG) is also stagnating at about 1 %.

WHO definition: Preterm birth refers to the termination of pregnancy at < 36 weeks of gestation (< 258 days p.m.).

With regard to research into pathogenesis, the following areas currently receive particular attention: maternal infections, anamnestic risk characteristics (previous miscarriages, preterm births, stillbirths and terminations of pregnancy) as well as psychosomatic factors. Rising rates of medically indicated preterm birth in the presence of maternal risk factors, e.g. obesity, gestational diabetes and cardiovascular diseases, are likewise being observed.