Preterm birth risks can be minimised with better care
Preterm birth is the birth of a baby before 37 weeks of pregnancy. In 2016, preterm birth affected 1 in 10 infants born in the US.
Every year 15 million babies are born preterm. Over one million of these die. Preterm birth is a leading cause of death among newborns. A developing baby goes through important growth throughout pregnancy, the final weeks being crucial for the growth of organs like brain, lungs and liver.
Effects of preterm birth
> Babies born too early have a higher risk of death and disability. Babies who survive may have breathing problems, feeding difficulties, cerebral palsy, development delays, vision/hearing problems and are prone to infections. > Long term problems may reflect in slow learning at school, motor disability and failure to gain weight. > Preterm births can take an emotional toll and be a financial burden to the family.
Risks factors for preterm birth
> Previous adverse pregnancy outcomes like previous preterm births, previous miscarriages especially in the second trimester, which can be due to weakness of the cervix. > Multiple pregnancy can double the risk of preterm delivery. > Medical disorders in mothers including diabetes, hypertension and clotting disorders put women at risk of early delivery, especially if not well controlled. > Infections in pregnancy like urinary tract infection, some vaginal infections and sexually transmitted infections can also increase the risk of preterm birth. > Physical characteristics like being underweight or overweight, lifestyle choices like smoking, drinking alcohol and drug abuse all contribute to early delivery. > Pregnancy at a young age, below 17 years or above 35 years, and having an inter-pregnancy interval of less than six months, can be risk factors for early delivery.
How to reduce the risk of preterm birth
> Early access to prepregnancy counselling and prenatal care. > Following strict protocols in assisted reproduction, by transferring only one embryo can reduce risk of multiple pregnancy.
Risk identification plays a very important role in planning prenatal care. Before pregnancy lifestyle modifications like pre-pregnancy, weight reduction, cessation of smoking, alcohol and drugs is crucial in reducing the risks.
During pregnancy screening and treatment of infections like urinary infection, dental caries and vaginal infection is important.
Screening for weakness of the cervix, by cervical length measurements and insertion of a protective stitch can help prolong pregnancy. At-risk women are also treated with hormone injections to prevent early delivery. Education about warning signs of preterm labour allows women to get to the hospital in time for certain interventions, to prepare the baby for an early delivery.
These interventions include administering steroids to mature the baby’s lungs, drugs to relax the uterus and antibiotics to avoid infection. Choosing a hospital with facilities and expertise for caring for preterm babies will improve outcomes markedly. A healthy start in life will go a long way in ensuring the health of the next generation.