Preterm birth is a term used to define infants who are born too soon, about 37 weeks or less. In the US, the rate of preterm birth is close to 13%. This rise is predominantly linked to increased multiple births due to artificial conceptions and increased indicated preterm births (e.g. maternal pre-eclampsia/eclampsia, intrauterine fetal growth restriction).
Preterm birth is an absolutely undesirable condition, which your obstetrician and pediatrician are trying to prevent from happening. Delivering your baby too soon will significantly decrease your baby’s potential for survival due to lung immaturity and low birth weight. Aside from survival, another important issue if the child is delivered preterm is the quality of life achieved by immature infants. Considerable physical and intellectual complications afflict many such children. Most of them manifest neurologic disabilities, including cerebral palsy. The last but not the least important issue is the economic impact of preterm birth. The dollar cost of successful perinatal intensive care and medical interventions are ballooning. Added to that, additional expenditures have to be incurred for long term outcomes and developmental handicaps during the remainder of childhood for many preterm infants.
Here are some things you can do lessen the risk for preterm delivery.
1. Seek prenatal care early or have more prenatal visits. Prenatal visits provide more window of opportunities for the expectant mother to be regularly examined by the health professional, counseled about nutrition, and educated about the entire process that she will go through.
2. Increase pregnancy spacing There is a heightened risk for preterm birth in pregnancies within close time proximity to a previous delivery. In fact, a greater than two-fold increased risk is noted for inter-pregnancy interval of less than 6 months. One explanation is that the uterus takes time to return to its normal state, along with its inflammatory status. Second, short interval pregnancy decreases the time to replenish the depleted maternal reserves of vitamins, minerals, and amino acids, consumed during the previous pregnancy.
3. Aim for a normal pre-pregnancy BMI (body mass index) The normal pre-pregnancy BMI is 19-25 kg/m².
4. Have adequate nutritional supplements Low concentrations of vitamins, minerals, proteins and calories in the body are associated with decreased blood flow and increased maternal infections, which both can potentially increased the risk for preterm delivery.
5. Avoid periodontal diseases Periodontal disease refers to any bacterial infection that destroy any tissues and supporting bone that hold the teeth in the mouth. In some studies, periodontal disease is linked with preterm birth. This is based on the idea that oral microbial pathogens may be transmitted hematogenously (carried by blood) to the female genital tract, triggering inflammatory reactions that culminates in preterm delivery.
6. Thoroughly inform your physician of your obstetrical, gynecologic, and medical history Women with history of previous preterm birth have increased risk of recurrence for preterm birth. Women should also alert their physicians of any suspicious symptoms of genital infections like vaginal discharge, so it can be treated early on. Some women also have incompetent cervix (painless cervical dilatation causing premature expulsion of the fetus). In such case, they are diagnosed by cervical ultrasound and may need a circumferential stitch around the cervix (known as cerclage) at the early stage of pregnancy. Furthermore, women should also alert their obstetrician for any medical illnesses they may be having like diabetes, asthma, hypertension, and seizures for appropriate management in order to prevent complications such as preterm birth.
7. Know the signs and symptoms of preterm labor These include contractions, pelvic pressure, back pain, and vaginal discharge.
8. Bed rest and hydration Adequate bed rest and hydration promote good circulation of blood, oxygen and nutrients to the growing fetus.
9. Avoid psychological and social stresses Depression, marital problems, and stressful conditions such as severe material hardship have been associated with preterm birth.
10. Avoid alcohol, tobacco and other substances of abuse Tobacco smoking is associated with increased inflammatory response that trigger the pathway leading to labor. It is also a powerful vasoconstrictor that compromises blood supply to the fetus, leading to fetal growth restriction and abruptio placenta, and consequently indicated preterm deliveries. Alcohol, on the other hand, can cause Fetal Alcohol Syndrome characterized by multiple physical defects, cardiac defects and intrauterine growth restriction.
It is important to remember that once preterm labor begins; there is not much a doctor can do. Hence, the best way to thwart the onset of preterm labor is for the pregnant woman to avoid risk factors associated with it.