Causes of Preterm Birth / Reducing Risks

Causes of Premature Birth

  • Late maternal age
  • Obesity
  • IVF treatment
  • Multiple births
  • Infection
  • Preeclampsia
  • Gestational diabetes
  • PPROM
  • Problems with the placenta
  • Problems with the cervix
  • Problems with the uterus
  • Problems with the baby’s development
  • Anti-Phospholipid Syndrome
  • A combination of medical conditions
  • One of more previous miscarriages or preterm births
  • Previous delivery of 4 or more children
  • High level of stress
  • Age below 18 or over 34 years
  • Previous fertility treatment
  • Short time between pregnancies
  • Severe illness of the mother
  • Vaginal Bleeding

 

Photo of a preterm child in an incubator.

 Reasons for increasing rates of preterm birth

  • Progress in research and intensive care
  • Increased number of multiple pregnancies as a result of increased use of assisted reproductive techniques
  • Possibility of early and planned caesarean section for optimal medical care of the preterm baby
  • Improved preventive care during pregnancy (thus a continuity of the pregnancy until the moment of a possible survival of the baby outside of the womb)
  • Increase in pregnancies of older women
  • Missing or insufficient education of pregnant women

 

Assessing Your Risk of a Premature Birth

Your antenatal checks will keep the medical team informed about the health of your growing infant and can determine your risk of a premature birth. If you are deemed to be at risk of a premature birth you may be offered additional tests that will aid your medical team spot potential problems and agree a care plan for the remainder of your pregnancy. These additional tests include:

  • Blood Tests
  • Urine Samples
  • Ultrasound Scans
  • Vaginal Swabs

Ultrasound scans can reveal a range of factors that have been linked to premature delivery.

These include:

  • The length of your cervix
  • The size of your womb
  • The size and position of your baby
  • Whether you are carrying more than one baby
  • Whether there are any problems with your baby’s development
  • The size and position of the placenta
  • The amount of amniotic fluid.

 

Possible developmental issues as a result of preterm birth

  • Developmental delay
  • Retinopathy of prematurity
  • Physical disability ie cerebral palsy
  • Deficiencies in social competence or the inability to integrate
  • Internal or external organ disorders (intestines, heart, lungs/BPD/asthma, hearing, visual or speech impairment)
  • Mental retardation
  • Learning disability or partial decreased performance (attention deficiency hyperactive syndrome, dyscalculia, dyslexia)
  • Bonding and interaction disorder
  • Feeding problems and failure to thrive

 

Prevention

For most women, pregnancy is a wonderful event.  Unfortunately, even with comprehensive care, too many babies are still born too early. Despite modern neonatal care, some of the children suffer from major problems after their birth and in later life.  Particularly at risk are children born well before their due date (before 32 weeks gestation) and/or very underweight (<1,500 grams birth weight).  Not every preterm child has such problems, but it has a markedly higher risk compared to children born at a much more mature stage. Therefore, doctors and parents should do their utmost to avoid a preterm birth.

Some signs of a possibly threatening preterm birth can be recognized in by specific observations and examinations, some of which the expectant mother can even carry out herself at home.

The best prevention is good medical supervision during pregnancy through regular participation in screenings and a health-supporting lifestyle. In the case of high psychosocial stress, competent support leading to a reduction of the burdening circumstances can contribute to the lowering of the preterm birth rate.

If preterm labour pains are detected or preterm birth is anticipated as a consequence of other causes, the child’s lungs can be matured by administering antenatal steroids to the mother (2 shots over a 24 hour period).

Preterm labour can be suppressed with medication (tocolysis) ie Magnesium Sulphate (which also has the added benefit of reducing the incidence of Cerebral Palsy in premature infants) and bed rest. This gains time for the lung maturity treatment and often achieves a prolonging of the pregnancy with a better prognosis for the child. In this manner the pregnancy can be extended from 24 to 26 weeks of gestation, which improves its survival chances by 25%.