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About Prematurity

I am going to use this page to educate about Prematurity. This is something that I have wanted to do for a long time. So hopefully everyone will take something away from this because it is a Silent Crisis, until you have lived it, you would never guess that so many baby's are born prematurely. Nearly 500,000 babies will be born prematurely this year.

Are you at risk?


Preterm labor and delivery can happen to any pregnant woman. But they happen more often to some women than to others. Researchers continue to study preterm labor and birth. They have identified some risk factors, but still cannot predict which women will give birth too early. Having a risk factor does not mean a woman will have preterm labor or preterm birth. It means she is more likely to have preterm labor or birth than other women.

Three groups of women are at greatest risk of preterm labor and birth:
  • Women who have had a previous preterm birth
  • Women who are pregnant with twins, triplets or more
  • Women with certain uterine or cervical abnormalities


If you have any of these three risk factors, it's especially important for you to know the signs and symptoms of preterm labor and what they do if they occur.


Lifestyle and Environmental Risks
Some studies have found that certain lifestyle factors may put a woman at greater risk of preterm labor. These factors include:

  • Late or no prenatal care
  • Smoking
  • Drinking alcohol
  • Using illegal drugs
  • Exposure to the medication DES
  • Domestic violence, including physical, sexual or emotional abuse
  • Lack of social support
  • Stress
  • Long working hours with long periods of standing


Medical Risks
Certain medical conditions during pregnancy may increase the likelihood that a woman will have preterm labor. These conditions include:

  • Urinary tract infections, vaginal infections, sexually transmitted infections and possibly other infections
  • Diabetes
  • High blood pressure
  • Clotting disorders (thrombophilia)
  • Bleeding from the vagina
  • Certain birth defects in the baby
  • Being pregnant with a single fetus after in vitro fertilization (IVF)
  • Being underweight before  pregnancy
  • Obesity
  • Short time period between pregnancies (less than 6-9 months between birth and the beginning of the next pregnancy)


Researchers also have identified other risk factors. For instance, African-American women, women younger than 17 or older than 35, and poor women are at greater risk than other women. Experts do not fully understand why and how these factors increase the risk that a woman will have preterm labor or birth.


What Can Women Do?
Remember, though, even if you have one of these risk factors, it does not mean you will have preterm labor. It just means that you are at greater risk than a woman who does not have a risk factor. Still, knowing you're at risk is scary. That's why it's so important that you:

  • Know the signs of preterm labor
  • Know what to do if you have any of them
  • Take very good care of yourself and your baby while you're pregnant

This is the best way to protect yourself and your baby against preterm labor and delivery.

The March of Dimes is funding research to better understand risk factors and the causes of premature birth.


Signs and Symptoms of Preterm Labor and What to Do

What Is Preterm Labor?
Preterm or premature labor happens when you go into labor before 37 completed weeks of pregnancy. This is too early for your baby to be born. Babies born too soon can have lifelong or life-threatening health problems.

Can Preterm Labor Be Stopped?
Many women are given drugs to delay or stop preterm labor. In some cases, birth can be delayed long enough to transport Mom to a hospital with a neonatal intensive care unit (NICU). Women may also be given medications that can improve the baby's health, even if the baby comes early.

Warning Signs
Here are the warning signs:

  • Contractions (your abdomen tightens like a fist) every 10 minutes or more often
  • Change in vaginal discharge (leaking fluid or bleeding from your vagina)
  • Pelvic pressure—the feeling that your baby is pushing down
  • Low, dull backache
  • Cramps that feel like your period
  • Abdominal cramps with or without diarrhea

What Should I Do If I Think I'm Having Preterm Labor?
Call your health care provider (nurse, doctor or midwife) or go to the hospital right away if you think you're having preterm labor, or if you have any of the warning signs. Call even if you have only one sign.

Your health care provider may tell you to: 

  • Come into the office or go to the hospital for a checkup.
  • Stop what you're doing. Rest on your left side for one hour.
  • Drink 2-3 glasses of water or juice (not coffee or soda).

If the symptoms get worse or do not go away after one hour, call your provider again or go to the hospital. If the symptoms get better, relax for the rest of the day.


Complications of Premature Birth

Many of us know a baby who was born too early and who is doing just fine. Most premature babies catch up to their full-term peers within a year or two of their birth. But some premature babies are not so lucky. Their low birthweight and insufficient physical development at birth result in lifelong health problems. Some of these children struggle every day to survive. The smallest or sickest die at birth or shortly afterwards. Babies born before 32 weeks of pregnancy are at greatest risk. To learn about the risks babies face when they are born before 28 weeks, from 28-31 weeks, from 32-35 weeks, or at 36 weeks, see the March of Dimes fact sheet on preterm birth. Here’s what you need to know about the most common medical complications a premature baby can face:

Respiratory Distress Syndrome (RDS): Babies with RDS lack a protein called surfactant that keeps the small air sacs in their lungs from collapsing. Luckily, many babies with RDS can be treated with synthetic surfactant. These babies also usually need help breathing with oxygen and sometimes a respirator (a machine that breathes for the baby). About 24,000 babies in the United States are affected with RDS each year. Most of these babies are born before the 34th week of pregnancy.

Intraventricular Hemorrhage (IVH): Intraventricular hemorrhage is the medical term for bleeding in the brain. Most bleeds occur in the first three days of life and get better by themselves with no or few lasting problems. Some severe bleeds require medical intervention and can cause brain damage (such as learning problems, behavioral problems and cerebral palsy). 

Necrotizing Enterocolitis (NEC): NEC is an inflammation that damages the intestine. It usually develops 2 to 3 weeks after birth. NEC can lead to feeding problems, swelling in the baby's belly and other complications. It is treated with drugs and sometimes surgery.

Retinopathy of Prematurity (ROP): ROP is an eye condition caused by the abnormal growth of blood vessels. It can result in vision loss and blindness. In some cases, ROP gets better by itself. In other cases, it is treated with a laser or cryotherapy (freezing). It occurs mainly in babies born before the 32nd week of pregnancy.

Chronic Lung Disease (also called bronchopulmonary dysplasia or BPD):  Babies who have this disease develop fluid in the lungs, scarring and lung damage, which can be seen on an X-ray. They are treated with oxygen and drugs. Their lungs usually improve over the the first two years of life. But many children develop a chronic lung disease resembling asthma. This condition can last for many years.

Infections: Premature babies are at higher risk of developing infections than full-term babies. Their immune systems are immature and not as able to fight off infections. Serious infections seen in premature babies include sepsis (a blood infection), pneumonia, and meningitis (infection of the membranes surrounding the brain). Infections are treated with antibiotics or antiviral drugs.

Anemia: Premature babies are often anemic. This means that they do not have enough red blood cells. Babies with anemia may have feeding problems and grow slowly. Anemia also can make heart or breathing problems worse. Anemia is treated with iron supplements and drugs that increase red blood cell production. In severe cases, the baby receives blood transfusions.

Patent Ductus Arteriosus (PDA): PDA is a heart problem that is commonly seen in premature babies. A large blood vessel (the ductus arteriosus) is supposed to close at birth so that the baby’s blood can circulate normally. In PDA, this blood vessel does not close. Drug treatment can help close the passageway. If that does not work, surgery is needed.

Apnea: Apnea occurs when a baby stops breathing for 20 seconds or more. The baby may also have a slow heart rate. Premature babies are constantly monitored for apnea. If a baby stops breathing, the monitor will sound. A nurse will stimulate the baby to start breathing by patting him or touching the soles of his feet. Sometimes after leaving the hospital, a baby uses an apnea monitor at home for some weeks.

Related inks

Harleyann's March of Dimes Hospital Band

Cerebral Palsy Reference and Resources

Premature.org

Retinopathy of Prematurity

Apnea of Prematurity

Prematurity Books

Care Pages

Prematurity Resource Center

Prematurity Resources

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