Labor that begins before the end of the 37th week is considered "preterm" or "premature." Approximately 1 out of every 10 babies born in the United States is born preterm.
No one knows the exact cause of preterm labor, but certain situations increase the odds for it, including:
- Preeclampsia, a form of high blood pressure that can develop in the second half of pregnancy.
- Maternal health problems such as kidney disease, diabetes, or heart disease.
- Multiple pregnancy. About 97% of twin pregnancies, for instance, result in preterm labor.
- Problems with the placenta, such as placenta previa or placenta abruptio.
- Problems with the uterus, such as structural defects, an incompetent cervix, or fibroids.
- Past preterm labor or delivery.
- Short intervals (less than a year) between pregnancies.
- Being younger than 18 or older than 40 during pregnancy.
- PROM (Premature Rupture of Membranes).
Other possible culprits include vaginal infections, poor nutrition, stress, depression, smoking, and alcohol and drug abuse.
Though prematurity is still one of the leading causes of infant death and disability in this country, medical advancements -- coupled with good prenatal care -- have drastically improved the chances that you'll bring home a healthy baby.
How Do I Know If I'm Having Preterm Labor?
Call your health-care provider right away if you notice any of these signs before your 37th week of pregnancy:
- More than five contractions an hour, or contractions that get longer, stronger, and closer together
- Abdominal cramps, pain, or pressure
- Lower back pain
- Spotting, bleeding, mucous, or watery discharge from your vagina
- Ruptured membranes
If your doctor suspects preterm labor, he'll do an exam to see if your cervix has dilated or your water has broken, and may gauge your contractions with a uterine monitor.
How Is Preterm Labor Treated?
If your doctor catches it early enough, it may be possible to postpone or stall preterm labor for a few crucial days or weeks. Some of the ways to postpone the preterm labor include:
- Bed rest
- Increased hydration with fluids, either orally or intravenously through a tube inserted in a vein
- Medication that stops the contractions
The medications that you may be given to stop preterm labor are called "tocolytics." These medications are usually given either subcutaneously as a series of shots, or through the vein, and can be highly effective. There are some side effects associated with these medications, including fast pulse, chest pressure or discomfort, dizziness, headache, feeling of warmth, shakiness, and nervousness.
Some women with preterm labor may need to remain in the hospital and some are able to go home once the preterm labor has stopped. The decision is usually based on how dilated your cervix is, and how far you are in your pregnancy.
If labor can't be stopped or you need to deliver early for another reason, your baby is at increased risk for a number of health problems, including:
- Respiratory distress syndrome (RDS) and other breathing problems caused by immature lungs
- Low birth weight (five pounds or less)
- Difficulty sucking and swallowing
- Bleeding in the brain, caused by underdeveloped blood vessels
- Digestive problems and infections that make it difficult to keep milk or formula down
- Jaundice, a yellowing of the baby's skin caused by an excess of bilirubin in her blood
Since a baby born too soon also has trouble maintaining her body temperature, your newborn may be kept in an isolette (an incubator) that helps her stay warm. If she has difficulty breathing, your doctor may insert a breathing tube into her trachea and supply oxygen with a respirator. If sucking and swallowing problems prevent her from feeding, the doctor may place a feeding tube into her stomach to provide her with nourishment. Extremely premature babies may need to be fed intravenously.
How Can I Prevent Preterm Labor?
Getting early, regular prenatal care drastically lowers the odds of preterm birth. See your health-care provider as soon as you suspect you're pregnant (or, even better, before you conceive) and get regular checkups throughout your pregnancy. Eat healthy foods and avoid cigarettes, alcohol, and drugs. Finally, talk to your health-care provider about other ways to ensure a healthy pregnancy.
Can My Doctor Do Anything To Help My Premature Baby Fare Better After Birth?
If he can't prevent or delay preterm birth, your doctor will check your baby's lungs with ultrasound or amniocentesis before you deliver. If they're not developed enough to handle life outside the womb, he'll give you drugs called cortocosteroids, which help your baby's lungs mature and reduce the odds of other complications after delivery.
When Can I Take My Baby Home?
That depends on how much treatment she needs. Most likely, your baby will stay in the hospital until she passes the five-pound mark and can breathe, eat, and maintain her body temperature on her own. Hospitalization could be days, weeks, or even months after delivery (depending on how early she was born). That means you'll probably go home before she does. Leaving your baby behind can be very stressful, so ask hospital personnel about counseling and other services available to you during this difficult time.
Review Date: June 29, 2001
Reviewed By: Peter Chen, M.D., Obstetrics and Gynecology, University of
Pennsylvania School of Medicine. Review provided by VeriMed Healthcare
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