What Are The Risks Of Preterm Labor?

Preterm labor is labor that occurs after week 20 and before week 37 of pregnancy. Preterm labor can result in premature birth. The earlier premature birth happens, the greater the health risks for your baby. Many premature babies (preemies) need special care in the neonatal ICU. Preemies can also have long-term mental and physical disabilities. This Blog covers all questions from - What is preterm labor? to What are the risks of preterm labor? Read on to Find out!

According to WHO, every year about 15 million babies are born prematurely around the world. Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born. In India, out of 27 million babies born every year (2010 data), 3.5 million babies born are premature.

Though occurrence of preterm birth is a global problem, but more than 60% of preterm births occur in Africa and South Asia. In the lower-income countries, on average, 12% of babies are born too early compared with 9% in higher-income countries.

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Signs and Symptoms

• Regular or frequent contractions. They may not be as painful.
• Belly pain with or without diarrhoea
• Constant low, dull backache
• Pressure in your pelvis or lower belly, like your baby is pushing down
• Mild abdominal cramps
• Vaginal spotting or light bleeding
• Preterm rupture of membranes — in a gush or a continuous trickle of fluid after the membrane around the baby breaks or tears
• A change in type of vaginal discharge — watery, mucus-like or bloody or more discharge than usual
• Your water breaks

Risks of Preterm Labor

Vaginal bleeding during pregnancy

Vaginal bleeding in the first and second trimester is linked with risk of premature birth. The risk is higher the longer the bleeding lasts.

Previous preterm labor or premature birth

The risk of premature birth is increased when getting pregnant within 6-18 months of previous delivery.

Pregnancy with twins, triplets or other multiples

Preterm labor occurs in twins and triplets because of larger uterine size, cervical weakness, growth abnormalities and complications with the placenta.

Problems with the uterus, cervix or placenta

Studies have shown that a short cervical length is associated with an higher risk of premature delivery. The normal uterus is Pear-shaped but some women are born with abnormally shaped uterus that can cause premature birth. The uterus can also be abnormal due to fibroids - solid masses that grow in the uterine muscle. They can be surgically removed if needed. Placenta previa and placenta abruption are risk factors for early delivery in the third trimester.

Smoking cigarettes, drinking alcohol or using illicit drugs

Smoking, drinking and/or using of drugs impacts your body as it is and it causes more harm during pregnancy which can result in premature labor.

Infections

Bacteria and viruses can work their way into the amniotic fluid and the baby through the blood stream or through the cervix. Most of the time the infection does not come to light till preterm contractions along with a fever don’t start. Unfortunately, there is no method to prevent this and when diagnosed, delivery is the only option.

Age of the mother

Women younger than age 18 are more likely to have a preterm delivery and those older than age 35 are also at risk of having preterm infants because they are more likely to have other conditions (such as high blood pressure and diabetes) that can cause complications requiring preterm delivery.

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Other risk factors

• Chronic conditions, such as high blood pressure and diabetes
• Stressful life events, such as the death of a loved one
• Too much amniotic fluid
• Presence of a fetal birth defect
• Urinary tract infections
• Sexually Transmitted Diseases
• Developmental abnormalities in the fetus
• Pregnancy resulting from IVF
• Being underweight or obese before pregnancy
• Placenta previa, a condition in which the placenta grows in the lowest part of the uterus and covers all or part of the opening to the cervix
• Being at risk for rupture of the uterus. Rupture of the uterus is more likely if you have had a prior caesarean delivery or have had a uterine fibroid removed.
• Diabetes and gestational diabetes (which occurs only during pregnancy)
• Blood clotting problems
• Late or no health care during pregnancy
• Domestic violence, including physical, sexual, or emotional abuse
• Lack of social support
• Stress
• Long working hours; are some of the risk factors of preterm labor.

Preterm Labor Complications

Complications of preterm labor include delivering a preterm baby. This can pose a number of health concerns for your baby. Some of which are:

• Low birth weight
• Breathing difficulties
• Underdeveloped organs
• Vision problems
• Higher risk of learning disabilities
• Higher risk of behavioural problems
• Inability to maintain body heat
• Immature gastrointestinal and digestive system
• Sepsis
• Jaundice
• Anemia

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How to Prevent Preterm Labor

Eat a healthy diet

Eating a healthy and balanced diet filled with nutrients that help the baby develop is essential. Some research suggests that a diet high in polyunsaturated fats - nuts, seeds, fish and seed oils , is linked with a lower risk of premature birth.

Exercise

Multiple studies suggest that exercising not only does not increase preterm labor, but decreases the chances of it. It was found that those who exercised were more likely to carry to term.

Regular prenatal care

Prenatal visits can help your health care provider monitor your health and your baby's health. Mention any signs or symptoms that concern you. If you have a history of preterm labor or develop signs or symptoms of preterm labor, you might need to see your health care provider more often during pregnancy.

Avoid risky substances

Smoking, drinking and Illicit drugs and alcohol are off-limits. If you smoke, ask your doctor to help you with a smoking cessation program.

Pregnancy spacing

Pregnancies spaced less than 6 months apart have an increased risk of premature birth.

Assisted pregnancies (IVF)

Be cautious with assisted pregnancies as the risk of preterm labor increases with it.

If you’re at an increased risk of preterm labor then your Doctor might recommend taking additional steps to decrease the risks:

Taking preventive medications

If you have a history of premature birth, your doctor might suggest weekly shots of a form of the hormone progesterone or other medication starting during your second trimester and continuing until week 37 of pregnancy. Consult your Doctor before taking any steps!

Managing chronic conditions

Diabetes, High blood pressure and other conditions like them increase the risk of preterm labor. Keeping these under control will help with preterm labor.

History of preterm labor

If you have a history of preterm labor or premature birth, you're at risk of a subsequent preterm labor. Work with your health care provider to manage any risk factors and respond to early warning signs and symptoms.

Preterm labor management

Management of preterm labour should be directed towards establishing the cause, ensuring delivery under optimal conditions, and consideration of the pros and cons of delaying delivery to increase gestational age. In practice, this means that women admitted in threatened preterm labour should be appropriately assessed to determine the optimal time for delivery

Corticosteroid Therapy

Once preterm labor is confirmed, a single course of corticosteroids is the only intervention for improving neonatal results. The use of corticosteroids is associated with decreased neonatal sickness and deaths. Infants whose mothers receive antenatal corticosteroids are less likely to display breathing problems among other things, compared with those whose mothers did not receive corticosteroids.

Magnesium Sulphate

Use of antenatal magnesium sulphate has been associated with a decrease in occurrence and severity of cerebral palsy in infants. But magnesium sulphate can cause maternal complications (e.g., respiratory depression, cardiac arrest). Consult your doctor before taking any steps!

Tocolysis

The function of Tocolytic agents is to delay the time to delivery so that antenatal corticosteroids and/or magnesium sulphate can be administered. Tocolytics have not been shown to directly improve neonatal outcomes, and they are not always indicated.

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