How can my doctor help if I’m at risk for preterm birth?

There are several risk factors for preterm birth, or birth that happens before 37 weeks of pregnancy, that a pregnant woman’s healthcare provider will keep an eye out for. One of the most significant ones is if she’s given birth early before. This is especially true if her last pregnancy was relatively recent, within the last 12-18 months.

Risk factors

Women who have an increased risk of preterm birth tend to show one or more of the following signs:

  • Previous preterm birth
  • Being pregnant with multiples
  • Prior cervical procedures or surgeries
  • Abnormally shaped uterus
  • Certain chronic health conditions like high blood pressure or diabetes
  • Smoking, drinking or drug use during pregnancy
  • Being underweight or obese before pregnancy
  • Certain infections during pregnancy
  • Being pregnant less than 18 months after a previous pregnancy
  • Pregnant under 17 years old or over 35

If a healthcare provider notices any of these signs, they may refer you to a specialist with experience in high-risk pregnancies, recommend a cervical assessment, prescribe certain medications, or keep a closer eye on the pregnancy with more frequent prenatal appointments. It’s also critical to speak with your healthcare provider about this before 16 weeks gestation, as many of the interventions would ideally start around this time.

You should let your healthcare provider know if you experience intense lower backaches, pelvic pressure, or vaginal bleeding, as they may all be signs of preterm labor.

Possible treatment

Preterm labor does not always end in preterm birth, and in about 30% of cases, it stops on its own while under observation at the hospital. In still other cases, labor can continue slowly. In cases of preterm labor that look like they’re heading towards preterm birth quickly, a doctor may administer medication to prepare the baby for birth, or to delay labor long enough for the woman to travel to a hospital that’s better prepared to look after preterm babies.

  • Corticosteroids are medications that cross the placenta and help accelerate fetal lung maturity and protect the brain and digestive system against complications that babies are at risk for if born early.
  • Magnesium sulfate is sometimes given during preterm labor that looks like it will end in preterm birth before 32 weeks of pregnancy to reduce the risk of cerebral palsy in the baby that is associated with preterm birth.
  • Tocolytics are medications that can help decrease preterm contractions and the incidence of preterm birth for up to 48 hours, giving new moms the time to receive corticosteroid treatment. It also allows women more time to get to a hospital or other medical facility that’s better prepared for premature births.

The complications of preterm birth can be serious, and women with infrequent medical care have an increased risk of facing them, but as medical knowledge has grown the chances of facing them have gone down. If your healthcare provider thinks you may be at risk for preterm birth, it’s important to keep an eye out for warning signs and preterm labor, but the fact that both you and your doctor are being vigilant is one of the most important parts of keeping both you and your baby safe.

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  • David G Weismiller. “Preterm Labor.” Am Family Physician. 59(3)593-602. Web. Feb 1 1999.
  • “Premature labor and preterm birth.” MarchofDimes. March of Dimes Foundation, Mar 2016. Web.
  • “Preterm (Premature) Labor and birth.” ACOG. FAQ 087 from American College of Obstetricians and Gynecologists, Sep 2015. Web.
  • “What is Premature Birth?” CDC. US Department of Health and Human Services, Nov 9 2015. Web.
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