Prematurity Awareness Month (World Prematurity Day on Nov. 17)

Premature infant in incubator in a hospital

Premature Birth:
What You Need to Know

Every year, an estimated 15 million babies are born preterm worldwide (before 37 completed weeks of gestation), with alarming increases yearly, according to the World Health Organization (WHO.) What’s more, WHO estimates approximately 1 million children die from complications of preterm birth each year. Of those babies born preterm, many endure death or lingering complications or disabilities throughout their lifetimes.

There are many sobering statistics concerning premature births:

  • Preterm birth complications are the leading cause of death among children under age 5 years worldwide. These complications are responsible for approximately 1 million child deaths in 2015 alone globally. Sadly, 75% of these deaths could have been prevented with current, cost-effective interventions.
  • Across 184 countries worldwide, the rate of preterm birth ranges from 5% to 18% of babies born.
  • In 2019, preterm birth affected 1 of every 10 U.S. infants, or 10% of infants born.
  • Preterm birth rates decreased from 2007 to 2014, with research by the Centers for Disease Control (CDC) research indicating this decline is due, in part, to declines in the number of births to teens and young mothers. However, preterm birth rate rose for the 5th straight year in 2019 within the U.S.
  • The CDC further iterates ethnic disparities in preterm birth rates continue to occur within the U.S. In 2019, the preterm birth rate among Black women (14.4%) was about 50% higher than the rate of preterm birth among white or Hispanic women (9.3% and 10% respectively.)
  • In the U.S., the preterm birth rate among Black women is 50% higher than the rate among all other women combined, according to the March of Dimes 2020 Report.
  • The U.S. is one of the highest-ranking countries where premature births occur, ranking 5th overall, with an estimated annual average of 500,000 premature births, according to WHO.

November is designated Premature Awareness Month, with November 17 designated as World Prematurity Day. Your local Capital Women’s Care team wants to share important information with you about: the sub-categories defining preterm birth; the short- and long-term health effects premature birth has on affected babies and mothers and important precautions women can initiate to optimize babies’ health and successfully carry them to full term.

What Is Prematurity?

Prematurity, also known as preterm birth, is when a baby is born before 37 weeks of pregnancy have been completed, according to WHO.

There are 3 sub-categories of preterm birth, based on gestational age, as defined by WHO:

  • extremely preterm (less than 28 weeks)
  • very preterm (28 to 32 weeks)
  • and moderate to late preterm (32-37 weeks.)

Complications for Preterm Babies

Research shows when compared to full-term babies (born at or after 39 weeks of pregnancy) babies who are preterm (born before 39 weeks) have:

It’s important to note not all preterm babies have complications. Complications vary and could be short-term or in some cases may last for longer duration, even into baby’s adult years.

Short-term complications for preterm babies may include:

Long-term complications for pre-term babies may include:

  • cerebral palsy
  • impaired learning
  • dental problems
  • behavioral and psychological problems
  • and chronic health issues such as infections, asthma and feeding problems.

Complications for Mothers of Pre-Term Babies

Mothers who deliver at or after 39 weeks of pregnancy typically have better outcomes than do mothers who deliver before 39 weeks. Mothers of pre-term babies usually face:

  • longer hospital stays post-partum
  • increased anxiety and fatigue
  • post-partum health issues, including post-traumatic stress disorder (PTSD), post-partum depression, and anxiety
  • less tactile involvement with baby post-partum due to baby’s NICU treatments and care.

Risk Factors of Preterm Birth

Some causes of preterm labor and premature birth aren’t known. In some instances, labor starts on its own without any warning. Even women who follow pregnancy health guidelines may still give birth early.

It’s important to establish a pre-pregnancy health plan before you become pregnant, ideally 3 months before you attempt to conceive. Establishing an individualized pre-pregnancy health plan with your Capital Women’s Care team optimizes not only your health, but that of your baby when you become pregnant, and reduces your risk of preterm labor and premature delivery.

You face greater risk of preterm delivery if:

  • you have had a premature baby in the past
  • you are pregnant with multiples (twins, triplets or more)
  • and/or you have problems with your uterus or cervix now or in the past
  • and you are younger than 17 years of age or older than 35.

In the U.S., Black women are more likely to give birth early, according to the March of Dimes. Almost 17% of Black babies are born prematurely each year. Just more than 10% of American Indian/Alaska Native and Hispanic babies are born early, and less than 10% of white and Asian babies. Researchers are prioritizing identification of the causes driving these pre-term birth disparities.

There are several medical risk factors for preterm labor and premature birth before pregnancy occurs, including:

  • being underweight or overweight before pregnancy, including having an eating disorder diagnosis, such as anorexia or bulimia.
  • having a family history of preterm birth. This means a close relative (your mother, grandmother or sister) has had a premature baby. If you were born prematurely, you are more likely than others to give birth early.
  • or becoming pregnant again too soon after having a baby. For most women it’s best to wait at least 18 months before getting pregnant again. Talk to your Capital Women’s Care team about the right amount of time for you.

Additionally, women having certain health conditions during pregnancy face increased risk for preterm labor and premature birth, including:

  • connective tissue disorders, like Ehlers-Danlos syndromes (EDS) and vascular Ehlers-Danlos syndrome (vEDS). Connective tissue is tissue that surrounds and supports other tissues and organs. EDS can cause joints to be loose and easy to dislocate; skin to be thin and easily stretched and bruised; and blood vessels to be fragile and small. It also can affect your uterus and intestines. vEDS is the most serious kind of EDS because it can cause arteries and organs (like the uterus) to rupture. EDS and vEDS are genetic conditions that can be passed from parent to child through genes.
  • diabetes, which occurs when too much glucose is found within the blood.
  • high blood pressure and preeclampsia. High blood pressure (also called hypertension) is when the force of blood against the walls of the blood vessels is too high. This can stress your heart and cause problems during pregnancy. Preeclampsia is a kind of high blood pressure some women experience during or right after pregnancy. If not treated, it can cause serious problems and even death.
  • infections, including sexually transmitted infections (STIs) and infections of the uterus, urinary tract or vagina.
  • intrahepatic cholestasis of pregnancy (ICP) is the most common liver condition that occurs during pregnancy.
  • thrombophilia are conditions that increase risk of making abnormal blood clots.

Other medical factors occurring during pregnancy can increase risk for preterm delivery, including:

  • getting late or no prenatal care. Prenatal care is medical care you get during pregnancy.
  • not gaining enough weight during pregnancy. This can include having an eating disorder, like anorexia or bulimia.
  • bleeding from the vagina in the second or third trimester.
  • preterm premature rupture of the membranes (PPROM) is when the amniotic fluid sac around your baby breaks before labor starts. PPROM is when this happens before 37 weeks of pregnancy. If you have any fluid leaking from your vagina, call your provider and go to the hospital.
  • being pregnant after in-vitro fertilization (IVF).
  • being pregnant with a baby who has certain birth defects, like heart defects, the most common type of birth defect, or spina bifida. Birth defects are health conditions that are present at birth which can cause problems in overall health, how the body develops or how the body works.

Fortunately, there are several risk factors identified that influence or cause preterm labor and premature birth that you can control through complete avoidance while you attempt to conceive or when you become pregnant. These include:

  • smoking, drinking alcohol, using street drugs or abusing prescription drugs
  • having a lot of stress in your life.
  • domestic violence, including physical, sexual and emotional abuse.
  • working long hours or standing on your feet
  • and exposure to air pollution, lead, radiation and chemicals in paint, plastics and secondhand smoke.

Tips to Reduce Your Risks

There are many things you can do to reduce your risk of preterm labor and premature birth that you can implement within your personal pre-pregnancy health plan:

  • Get to a healthy weight before pregnancy and gain the right amount of weight during pregnancy. Talk to your Capital Women’s Care team about the right amount of weight for you before and during pregnancy.
  • Don’t smoke, drink alcohol, use street drugs or abuse prescription drugs. Ask your Capital Women’s Care team about programs to help you quit. Also verify with your practitioner the safety of all over-the-counter medications and supplements you are taking, especially if you wish to conceive or are pregnant.
  • Schedule your first prenatal care checkup as soon as you think you’re pregnant. During pregnancy, go to all your prenatal care checkups, even if you’re feeling fine. Prenatal care helps your provider make sure you and your baby are healthy.
  • Get treated for chronic health conditions, such as high blood pressure, diabetes, depression and thyroid problems.
  • Protect yourself from infections. Talk to your provider about vaccinations that can help protect you, as well as your unborn baby. Wash hands with soap and water after using the bathroom or nose blowing; avoid eating raw meat, fish or eggs; practice safe sex; avoid touching cat feces to avoid toxoplasmosis exposure.
  • Reduce your stress. Eat healthy foods and do something active every day. Ask family and friends for help around the house or taking care of other children. Get help if your partner abuses you. Talk to your boss about how to lower your stress at work.
  • Wait at least 18 months between giving birth and getting pregnant again. Use birth control until you’re ready to get pregnant again. If you’re older than 35 or you’ve had a miscarriage or stillbirth, talk to your Capital Women’s Care team about how long to wait between pregnancies.

Your Capital Women’s Care team is here to help you establish an individualized pre-pregnancy health plan and answer your questions pertaining to pregnancy or any women’s health issue. Our team of compassionate, expert professionals strive to provide you with comprehensive, personalized care throughout all your stages of life so you may enjoy optimal health and a long life.

Suggested Sources:

https://www.marchofdimes.org/complications/preterm-labor-and-premature-b...
https://www.verywellfamily.com/premature-birth-facts-and-statistics-2748....
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth...
https://www.who.int/news-room/fact-sheets/detail/preterm-birth
https://www.cdc.gov/nchs/products/databriefs/db312.htm
https://www.marchofdimes.org/pregnancy/week-by-week.aspx#28
https://khn.org/morning-breakout/pre-term-birth-rates-worsen-for-fourth-...
https://www.marchofdimes.org/mission/reportcard.aspx
https://www.nichd.nih.gov/health/topics/preterm/conditioninfo/who_risk
https://www.marchofdimes.org/complications/long-term-health-effects-of-p...
https://www.mayoclinic.org/diseases-conditions/premature-birth/symptoms-...
https://www.ccjm.org/content/87/12/759
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5660765/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098830/
https://www.healthline.com/health/pregnancy/premature-baby-complications

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