Premature birth

What is preterm birth?

Preterm birth is the birth of a baby too early, before 37 weeks or 8½ months.

Globally, more than 1 in 10 babies are born preterm. Preterm birth can cause health problems because the baby's organs may not be fully developed yet.

Why do I need to know about preterm birth?

Preterm birth is the biggest cause of newborn deaths worldwide. Over a million babies die each year due to being born too soon.

By knowing the risks, noticing early warning signs and understanding the treatments, sometimes you can take action to help both yourself and your baby.

What are the risk factors for preterm birth?

There are many reasons why a baby might be born early. These can be grouped into three types:

• Non-changeable – for example, having had a preterm birth before, being under 18 or over 35, carrying twins or other types of multiple pregnancy, having a uterine abnormality, such as short cervix or fibroids, or a history of late miscarriage or cervical surgery.
• Somewhat changeable (modifiable) – for example, stress, depression, domestic violence or hard physical work.
• Changeable (modifiable) – for example, infection during pregnancy (e.g. urinary tract infection, sexually transmitted infection, vaginal infection), high blood pressure, poor diet (e.g. low iron or folic acid), smoking or second-hand smoke, short gap between pregnancies (less than 24 months) or not attending antenatal appointments.

How can I prevent preterm birth?

While not all preterm births can be prevented, there are many steps you can take to lower your chances of preterm birth:

• Go to all your antenatal appointments
• Eat nutritious food like green vegetables, beans, fruit and whole grains
• Treat infections early (e.g. urinary or vaginal infections)
• Do not smoke or take illegal drugs and avoid alcohol
• Space pregnancies by at least 24 months
• Reduce stress where possible and seek help if you are not safe at home or are experiencing domestic violence
• Manage any existing health problems, such as diabetes or high blood pressure

These steps can make a big difference in keeping your pregnancy healthy.

What medical treatments can help prevent preterm birth?

If you are found to be at higher risk of preterm birth, your healthcare provider may offer:

• Vaginal progesterone: this is a hormone treatment that can help prevent early labor, especially if you have a short cervix.
• Aspirin in a low dose: this is to help prevent high blood pressure-related complications like pre-eclampsia.
• Cervical cerclage (a stitch in your cervix): this is a procedure to strengthen the cervix if it is weak or short in certain situations, only if recommended by a specialist doctor.

What are the signs that I might be going into preterm labor?

If you are less than 37 weeks or 8½ months pregnant and have any of these then see your healthcare worker as soon as possible:

• Regular tightening or contractions in your abdomen
• Period-like pain or strong cramping
• A sudden gush or steady trickle of fluid from your vagina (waters breaking)
• Unusual backache that does not go away
• Bleeding from your vagina

Some of these symptoms may seem like normal pregnancy discomforts, but if they are strong, regular or unusual for you, get checked. Early action can help keep you and your baby safe.

What happens if I go to hospital with preterm labor?

If you go into preterm labor, healthcare workers may:

• Give you an injection of corticosteroids to help your baby’s lungs develop
• Give you a drip with magnesium sulfate to protect your baby’s brain
• Start you on antibiotics to prevent infections such as Group B streptococcus

It is very important that you give birth in the right place, with the right facilities to help you and your baby.

What happens if my baby is born too soon?

• Your baby may need care in a neonatal unit (NICU) for help with breathing, feeding and warmth
• You may be asked to do kangaroo care (skin-to-skin contact), which helps your baby stay warm, gain weight and bond with you
• You may be encouraged to breastfeed or express milk, which gives your baby important nutrients and protection from infections

What to do in the future?

If you’ve had a preterm birth before, it is very important to seek early care in your next pregnancy. Healthcare workers can monitor you more closely and offer treatments to lower the chance of another preterm birth.