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Published on November 25, 2013

Reducing Your Risk and Preventing Premature Births

A Dean Clinic physician helps educate the public during Prematurity Awareness Month

Every year, one in eight American babies are born premature. These early births can have serious medical implications, but there are ways to reduce a mother’s risk of going into preterm labor.

What is considered a “premature” birth?

Any birth before 37 weeks of gestation, or at least three weeks before the baby’s due date, is considered premature. Because important growth and development continues through the final weeks of pregnancy, carrying a child to full term is extremely important for the baby’s future health. 

“While there are some medical complications that may require a woman and her doctor to induce an early delivery, about 80 percent of premature deliveries happen because the mother goes into labor early or because her water breaks,” says Dr. Brian Stafeil, a perinatologist and obstetrician at Dean Clinic.

What medical complications are most often associated with a premature birth?

According to the Center for Disease Control, premature births account for a large portion of infant deaths in the US. For babies born prematurely, medical concerns can range from jaundice to severe mental and physical disabilities. Even babies born between 30-34 weeks are at an increased risk for jaundice, respiratory disease, hypoglycemia and bacterial infection.

Beyond the first weeks and months, children who are born prematurely often have life-long medical complications.

“Preterm survivors are more likely to have impaired cognitive skills, motor deficits including cerebral palsy, sensory impairment including hearing and vision loss, and behavioral and psychological problems as the grow up,” says Stafeil.

For mothers who give birth prematurely, the complication risks are very similar to full term deliveries.

“There is a risk of bleeding and infection as in any other delivery,” says Stafeil. “Preterm fetuses are more likely to be in breech or transverse lie position and those positions require a cesarean delivery.”

What causes premature birth?

When it comes to predicting premature birth, there are many risk factors to consider:

  • history of preterm birth
  • waiting less than six months between pregnancies
  • reproductive help (like in vitro fertilization)
  • carrying multiple fetuses (like twins or triplets)
  • infection
  • vaginal bleeding
  • asymptomatic bacteria (which is bacteria in the urine without symptoms of a urinary tract infection)
  • increasing age
  • smoking and other substance abuse

Other cervical and uterine factors like a short cervix, cervical surgery or uterine malformation can also cause premature birth. 

Race does seem to play a part in premature birth rates. For unknown reasons, African American women are more likely to experience premature births than women of other races.

What can a mother do to reduce her risk for premature birth?

Dr. Stafeil recommends working with your doctor to avoid the early induction or scheduling an early C-section if it is not medically necessary. For women undergoing assisted reproduction, like in vitro fertilization, reducing the number of embryo transfers can reduce the risk of premature birth.

Maintaining a healthy lifestyle before and during pregnancy also helps.

“Prenatal care is imperative and preconception counseling is essential for women with underlying medical conditions in order to optimize their health prior to pregnancy in an effort to reduce preterm deliveries,” says Stafeil.

When it comes to prenatal care, all women should talk with a healthcare professional. If you have a history of preterm births or other medical conditions, there may be something your doctor or midwife can do to help you carry your baby to full term.

It's also important to know the signs of early labor.  They can include the following:                                                                                                                                                                             

  • Menstrual-like cramping
  • Low back ache (especially intermittent)
  • Mild, irregular contractions
  • Vaginal pressure
  • Vaginal discharge of mucus

“Unfortunately, these symptoms are nonspecific and don’t always indicate a woman is at risk of preterm delivery,” says Stafeil.

If you think you are going into preterm labor, contact your doctor immediately.