Preterm Birth

Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age. The World Health Organization (WHO) defines preterm birth as babies born alive before 37 completed weeks of pregnancy.

Causes and Risk Factors

The exact cause of preterm birth is often unknown, but several risk factors have been identified, including:

• Pregnancy with multiple fetuses (twins, triplets, etc.)
• History of preterm labor or premature birth in a previous pregnancy
• Certain uterine or cervical abnormalities
• Infections during pregnancy, such as urinary tract infections or bacterial vaginosis
• Chronic medical conditions, such as high blood pressure, diabetes, or kidney disease
• Poor nutrition and inadequate prenatal care
• Smoking or substance abuse during pregnancy
• Stress and anxiety during pregnancy

Symptoms and Diagnosis

The symptoms of preterm labor may include:

• Regular uterine contractions that cause the cervix to begin to open
• A low, dull backache
• A feeling of pressure in the pelvis or vagina
• Bleeding or spotting
• Rupture of membranes (the breaking of water)

Diagnosis is typically made through a combination of physical examination, medical history, and diagnostic tests, such as:

• Pelvic exam to check for cervical dilation and effacement
• Fetal monitoring to assess fetal heart rate and well-being
• Ultrasound to confirm gestational age and fetal development

Treatment and Management

The goal of treatment is to delay or prevent preterm birth, if possible. Treatment options may include:

• Bed rest or reduced activity to minimize stress on the uterus
• Corticosteroids to promote fetal lung maturity
• Tocolytic medications to slow or stop uterine contractions
• Antibiotics to treat underlying infections
• Cervical cerclage (a surgical procedure to close the cervix)

Complications and Outcomes

Babies born preterm are at increased risk for a range of complications, including:

• Respiratory distress syndrome (RDS)
• Necrotizing enterocolitis (NEC)
• Intraventricular hemorrhage (IVH)
• Retinopathy of prematurity (ROP)
• Cerebral palsy and other neurodevelopmental disorders

The outcome for preterm babies depends on various factors, including gestational age at birth, birth weight, and the presence of any underlying medical conditions.

Prevention

While not all cases of preterm birth can be prevented, certain measures may reduce the risk, such as:

• Prenatal care and regular check-ups with a healthcare provider
• Avoiding smoking and substance abuse during pregnancy
• Maintaining good nutrition and a healthy weight
• Managing chronic medical conditions
• Reducing stress and anxiety through relaxation techniques or counseling

Frequently Asked Questions (FAQs)

What is preterm birth?
Birth before 37 weeks of pregnancy.

What causes preterm birth?
Often unknown, but can be due to medical conditions or pregnancy complications.

What are risk factors for preterm birth?
Previous preterm birth, multiple gestations, cervical insufficiency.

Can preterm birth be prevented?
Some cases can be prevented with proper prenatal care and management.

How is preterm birth diagnosed?
Through ultrasound and fetal monitoring.

What are symptoms of preterm labor?
Contractions, back pain, vaginal bleeding or discharge.

How is preterm labor treated?
With medications to delay birth and corticosteroids for fetal lung development.

What are complications of preterm birth?
Respiratory distress, infection, developmental delays.

Can babies born preterm survive?
Yes, with proper medical care and support.

What is the long-term outlook for preterm babies?
Varies depending on gestational age and presence of complications.