Premature Birth: Understanding Your Risk
Dr. Jill Hechtman is the Medical Director of Tampa Obstetrics and the past Chairman of Obstetrics and Gynecology at St. Joseph’s Women’s Hospital in Tampa. She is the past Chairman of Obstetrics and Gynecology at Brandon Regional Hospital and served on the hospital’s Board of Trustees for 2 years. She is a frequent face in local media as “Dr. Jill” and currently is the obstetrics and gynecology expert for “Daytime,” a nationally syndicated talk show. Jill was also recently appointed as a member of the Florida House of Representatives Medicaid Low Income Pool Council. She is also featured in various videos about pregnancy, which can be found on this website under “Patient Education.”
It is estimated that approximately 1 in 10 pregnancies in the United States will result in a premature birth–this is one of the highest rates in the developed world. Premature birth remains the leading cause of newborn death globally, and it can happen to anyone. Although its prevalence is remarkably high, premature birth remains a puzzle for medical professionals across the world who struggle to identify why so many babies are born too early.
Premature birth is defined as delivering between 20 and 37 weeks. Since babies are technically not ready to leave the womb, they are subject to a variety of physical and developmental challenges if they are born early. Some of the short-term challenges include: brain bleeds, heart problems, lung and breathing issues, challenges with regulating body temperature, and gastrointestinal conditions. Additional long-term conditions like vision, hearing, and dental problems can occur, along with behavioral and psychological problems.
Needless to say, premature birth is a serious health issue that all expectant moms should know about.
Who is at risk for premature birth?
If you have had a premature birth previously, this is your biggest risk factor for potentially delivering early again. There are other common risk factors that raise red flags for doctors, including: problems with the cervix or placenta, short intervals between pregnancies, infection, or other health conditions such as high blood pressure or diabetes. Conceiving via in-vitro fertilization (IVF), carrying multiples (twins or triplets), poor nutrition and diet, or drug and alcohol abuse may also put you at risk. All of this being said, 40% of women give birth prematurely are first time moms and about 50 percent of those who deliver early have zero symptoms!
Is there any way to prevent premature birth?
Leading a healthy lifestyle while you are pregnant is the first step to having a healthy baby. Furthermore, having as much information as you can about your pregnancy and developing baby is also an important way to ensure the health of your unborn child.
Here are some tips to help you proactively manage your pregnancy:
Familiarize yourself with the symptoms of premature labor.
Premature labor means your body is preparing for birth earlier than your due date. Some of these warning signs include: cramping in the lower abdomen (similar to menstrual cramping), a dull backache, frequent contractions that exist in 10 minute-or-less intervals, increased pelvic pressure (like your baby is pushing down), and vaginal bleeding or fluid leaking from the vagina. If you experience any of these symptoms prior to your due date, call your doctor immediately.
Predict your risk of delivering early with a new blood test.
A new prenatal test recently became available that predicts your individualized risk of having a premature birth. The PreTRM test is a blood test, ordered by your doctor, that is taken during the 19th or 20th weeks of pregnancy. The PreTRM test measures and analyzes specific proteins in the blood that have been shown to be highly predictive of premature birth. If you’re carrying one baby (not twins!) and don’t have symptoms, this test can provide you and your doctor helpful insight into your pregnancy and whether you may be at risk for delivering early.
Knowing your risk of premature birth provides doctors with important information they need to proactively monitor the pregnancy and intervene if the result is high-risk. There are established interventions designed to help prolong a pregnancy, including: increased surveillance or monitoring (cervical length measurements, screening for infection), progesterone therapy, pelvic rest, and an increase in doctor visits to monitor the baby. Being informed that you are high-risk also gives you the opportunity to prepare for an early delivery and identify the right hospital and specialists to care for your baby after delivery. Alternatively, receiving a low-risk result can provide you with peace of mind and reassurance that the pregnancy is progressing according to plan–one less thing to worry about!
Pregnancy is a time of great joy and excitement, but also of anxiety and nerves. Having as much information as possible about the health of your growing baby can help put your mind at ease, particularly as it relates to premature birth. As I often tell my patients—every 24 hours is a miracle. Every day that a baby can remain in utero is an extremely positive, significant step in baby’s development. Knowledge is power—the more information you have about your baby, the better prepared you will be to ensure the health of your newborn child.