For More Babies, Birth Comes Too Soon

Full-term babies are born between 37 and 42 completed weeks of pregnancy.  Babies born prior to 37 weeks gestation are considered premature. More than half a million babies are born before they have reached 37 weeks of maturity.

Premature babies have an increased risk for complications, such as respiratory distress syndrome and infections. Most preterm babies spend weeks or months in a hospital's Neonatal Intensive Care Unit (NICU). A NICU has a specialized team of nurses and doctors that can care for the special needs of premature babies.  

The problems don't end with discharge. Preemies can face respiratory distress, brain damage that includes cerebral palsy and learning disabilities, digestive problems, and hearing and vision loss. Complications can follow them through life.

Early birth also includes risks for lower birth weight and immature organ development that can lead to long-term physical, social, and learning disabilities.

Suspected factors

Experts suspect the sharp rise in preterm births may be linked to the rise in assisted reproduction. This leads to riskier multiple births and more medically assisted deliveries (such as cesarean sections). The rise in obesity and diabetes may play a role, too.

The cause stays a mystery in about half of preterm births. There is no way to predict who will deliver early, although vaginal ultrasounds may help. But certain factors boost the risk for certain women:

• Abnormalities of the uterus, cervix, or placenta

• Being younger than 20 or older than 35

• Previous preterm births (even being born early yourself)

• Poor or no prenatal care

• Poor nutrition (such as being underweight)

• Sexually transmitted infections

• Vaginal infections

• Smoking or alcohol abuse

• Excess stress

• Domestic violence before or in pregnancy

Many of these factors can—and should—be addressed before conception. It's important to get early and regular prenatal care to help identify risks and problems as soon as possible.

Strategies that may help:

• Commit to a healthy lifestyle. Avoid smoking and alcohol, control your weight, lower your stress, and add a folic acid supplement. Doctors recommend 400 mcg of folic acid a day. Taking folic acid even a month before you conceive seems to limit preterm births, studies show. Folic acid also prevents certain birth defects. Eat lots of folic-acid-rich foods, too, such as oranges, leafy greens, and fortified cereals.

• Treat pre-existing conditions. These include sexually transmitted infections, vaginal infections, diabetes, high blood pressure, and even gum disease.

• Use the right tactics for multiple pregnancies. The chances of premature birth rise if you carry more than one baby. Doctors may suggest bed rest.

• Be wary of "scheduling" birth. It's not always easy to pin down due dates. Opting for a cesarean section delivery that's not medically required, or inducing labor when you think the baby is due, could lead you to deliver a baby who hasn't reached full gestation.

• Space out pregnancies. Getting pregnant within nine months of giving birth raises preterm risk. Delivering at 18-month to five-year intervals lowers the risk.

• Be alert for signs of early labor. These include regular contractions, vaginal spotting or bleeding, and a low, dull backache. Early labor may be halted with bed rest on your left side, interventions to slow contractions, or hormone injections to extend pregnancy. Talk with your health care provider.