According to the World Health Organization (WHO), just over 1 out of every 10 babies are born preterm worldwide. A preterm birth is when a baby is born earlier than 37 weeks [1]. In countries with high accessibility and a higher quality of obstetric healthcare (like the United States), almost all premature babies survive. However, most of them need special care [2].
What is a preterm birth?
A preterm birth, also referred to as a premature birth is when the delivery of a baby happens between week 22 and 37 of pregnancy. Although babies will develop throughout pregnancy, the final weeks of pregnancy are typically where the essential organs such as the brain, lungs and liver fully develop [1]. Preterm births are classified according to how early baby is born [2]:
extremely preterm, before week 28;
preterm, between week 28 and 32;
moderately preterm, between week 32 and 37.
The later the baby is born during pregnancy the better. This helps to prevent any health complications for both mother and baby. The WHO does not recommend that your doctor induce labor or perform a C-section before 39 weeks unless medically indicated [2].
What does “medically indicated” mean?
In some extreme situations a preterm birth may be advised or "medically indicated" by health professionals. For example if a mother or baby’s life is threatened by conditions such as preeclampsia, oligohydramnios, or intrauterine infections a doctor may recommend inducement or a C-section, even though it is early in the pregnancy. In this instance having a preterm birth carries less of a risk than the other health conditions which have the potential to be life threatening [3].
What can cause preterm birth?
Some of the most common risk factors for a preterm birth are [3]:
A previous preterm delivery;
A placenta preview (this is when the placenta attaches lower in the uterus);
A pregnancy with twins or other multiples;
Preeclampsia;
Oligohydramnios;
Tobacco use;
Premature rupture of membranes;
Cervicovaginitis;
Urinary tract infection.
Can I prevent preterm birth?
If you have one or more risk factors for a preterm birth your doctor will see you more often in order to monitor your pregnancy more closely. It’s possible that you will need to treat any infections or conditions with medical therapies, a low sugar diet, or other prescriptions. If you carry a high risk for preterm delivery, your doctor may give you magnesium sulfate before week 32 to lessen the risk of neurological disorders such as cerebral palsy in the baby [4].
If you are already in preterm labor, you will be admitted to the hospital, and the medical staff will take all necessary actions to make sure the baby is born safely. This may include regulating the baby's body temperature with an incubator (thermal care) and continuous positive air pressure therapy or oxygen therapy for respiratory issues [4].
When do I need to go to the hospital?
If you have regular contractions;
If you feel pain in your lower back and abdomen;
If your amniotic fluid is leaking (even if you have no contractions).
Depending on your symptoms and signs, your doctors will look for ruptured membranes, perform a vaginal exam, and monitor the baby's heartbeat. You may receive an ultrasound and a urine exam to check for infections.
If all tests show normal results, your preterm labor will likely stop (as it does for 3 in 10 women). If labor continues, your doctors will proceed with delivery [1].
If I give birth prematurely, will I be able to hold my baby?
It depends on the baby's condition and what immediate care is needed. If the baby can breathe on their own, they will be laid on the mothers chest. This natural and loving skin-to-skin contact, plus frequent breastfeeding, is called kangaroo mother care. It’s not only an emotional relief for both mother and baby, but actually boosts the baby’s ability to thrive [4].
This article was created in association with UNFPA, the United Nations sexual and reproductive health agency.
