Born Too Soon

It is estimated that 15 million babies are born too soon every year.  That is more than 1 in 10 babies.  Prematurity is the biggest cause of death of children under 5 worldwide and those that do survive often have a lifetime of health problems including cerebral palsy, visual and hearing problems, chronic lung disease, heart problems and learning disabilities.

A premature birth is one that takes place more than three weeks before the baby’s expected due date (40 weeks).  But if a baby is born before 32 weeks it will be at greater risk of serious complications.

Why are babies born too soon?

There are a variety of reasons for babies being born too soon. Most happen spontaneously but some can be for medical reasons.  In some countries such as USA, the rate of preterm birth is actually rising in spite of improved care of the mother and foetus.  Here are some of the common causes of preterm birth (PTB):

Family history

  • genetic
  • ethnicity
  • family history – mother being born prematurely has a higher risk of a premature baby

Age of mother

Most at risk of PTB are teen mothers especially aged 17 and under or older mothers 35 years and over

Pregnancy-related problems

  • Abnormal shape of uterus or cervix opening too early
  • Pre-eclampsia or foetal growth restriction
  • Infections in lower female reproductive tract such as bacterial vaginosis
  • Chronic conditions such as diabetes, obesity and high blood pressure

Pregnancy History

  • Miscarriage – in a previous pregnancy
  • Previous preterm delivery                          
  • Abortion – becoming pregnant within six months after an abortion may increase the risk

Twins or multiple babies

  • 60% twins and 90% triplets are usually born preterm

Stress during pregnancy

If the mother is stressed her body can release chemicals such as cortisol and epinephrine which release a hormone, corticotrophin.  This hormone can increase levels of estriol and prostaglandins in the body that may result in preterm labour

Short gap between pregnancies. 

Pregnancy has a draining effect on the mother’s body which then needs time to recover.  If a new baby is conceived too soon after the birth of the previous baby the body may not be ready to support a new baby.  Ideally the body needs at least 18 months to prepare for a new pregnancy

Alcohol and smoking

Alcohol and smoking not only increase the risk of premature birth but also lead to other complications for either the mother eg complications in the placenta or the baby such as low birth and maybe even death of the baby

So many causes may increase the chance of preterm birth but sometimes no cause can be identified.  As the causes and mechanisms for preterm birth are better understood the advancement of solutions will help prevent this.

What can be done?

Educating yourself about the risks of preterm labour

Having a healthy diet and maintaining your recommended weight

Eliminating or reducing tobacco, alcohol and drug use

Keeping fit with gentle exercise suitable for pregnancy such as walking and yoga

Cleaning your teeth.  Mothers with periodontal disease seem to have a higher risk for very early delivery

Access to health professionals who can monitor the foetus using ultrasound to determine its gestational age and detect multiple pregnancies, and measure the mother’s cervix to see whether she is at risk of giving birth prematurely.

Regular visits to health professionals (WHO guidelines recommend a minimum of eight contact throughout pregnancy) enables other risk factors such as infection, gestational diabetes etc to be identified.

Ensuring a healthy gap between pregnancies so better access to contraceptives could help reduce preterm births

If you are pregnant and at risk of going into premature labour you should make sure that your doctor is aware of your risks.  You may be monitored more frequently and closely.

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