Understanding Preterm Birth

Outlining the Risks

An average pregnancy lasts around 40 weeks, and babies born sooner than this have an increased chance of complications. While there are numerous challenges that can arise from preterm birth, advancements in medicine and general understanding have led to better outcomes in recent years. Read on for insight from neonatologist Dr. Nicholas Sherrow of Regional Neonatal Specialists at Hamilton Medical Center.

What is Preterm Birth?

When a baby is born before 37 weeks of pregnancy, this is known as a preterm birth. The reason that preterm birth can be so dangerous is that those last few weeks are an important time for the development of critical organs including the brain, the lungs, and the liver. For this reason, babies born too early – particularly before 32 weeks – have a higher mortality rate and an increased chance of disability, including breathing problems, feeding difficulties, cerebral palsy, developmental delays, impaired vision, and impaired hearing.

Risk Factors for Preterm Birth

preterm infant receiving treatment

There are many causes of preterm birth. According to Dr. Sherrow, “Unfortunately, the most common and frustrating reason is from an unknown cause. Other known reasons include your age, carrying multiple babies, your ethnic background, history of prior preterm birth, and your overall health status. Acute problems, such as bleeding, infection, high blood pressure, and placental issues, can occur at any point during pregnancy and can lead to a preterm birth.”

Currently, about 1 in 10 babies are born prematurely in the United States. In 2022, 10.4% of all live births were premature, but there are racial and ethnic disparities within that overall percentage. That same year, the preterm birth rate was 14.6% among Black women – roughly 50% higher than it was for Hispanic women (10.1%) and white women (9.4%). While researchers have not yet pinned down a definitive reason for this difference, recent studies suggest that socioeconomic challenges – such as access to healthcare, environmental exposures, and whether or not a woman has the ability to properly rest and minimize stress during pregnancy – play a key role.

adult holding infant baby's feet

How Can You Reduce the Risk of Preterm Birth?

According to Dr. Sherrow, a very important factor in the risk of premature birth is the mother’s pre-pregnancy health. “Having medical conditions that are not well controlled can increase the risk of a preterm birth. You would also want to stop habits that could lead to early delivery like tobacco and recreational drug use, including marijuana and delta 8,” he shares. “First, follow the advice of your OB. OBs are trained professionals who provide medical guidance to help decrease your chance of a preterm birth. Second, take care of yourself. Being pregnant is a strenuous process. Take time for yourself and get plenty of mental and physical rest.”

The causes of preterm birth can be complex and are not always easy to understand, but there are some general guidelines that can help improve your chances of having a healthy pregnancy.

  • Stop smoking: smoking leads to preterm birth and low birth weight – two of the greatest risk factors for otherwise healthy babies.
  • Avoid alcohol: alcohol consumption in the second and third trimesters has been associated with increased risk of preterm birth, with heavy drinking (an average of three or more drinks per day) increasing this risk by four times. 
  • Plan pregnancies: babies conceived within 18 months of the last pregnancy are at higher risk of preterm birth and low birth weight – it is important to give your body enough time to heal after a pregnancy to avoid these risks.
  • Manage maternal health: Eat well, try to reduce stress, seek prenatal care as soon as possible, and closely follow your physician’s instructions – routine appointments throughout pregnancy can help identify potential abnormalities and address them sooner.
  • Don’t delay: seek medical attention as soon as possible if you experience warning signs of preterm labor.

Signs of Preterm Labor

The body changes during pregnancy, and this can be particularly worrisome for first-time mothers or mothers who have previously experienced a preterm birth. It can be difficult to differentiate normal changes from the signs of preterm labor, but if you experience any of the following symptoms it is important to seek medical attention immediately:

  • Contractions that occur every 10 minutes or more frequently
  • Changes in vaginal discharge such as increased discharge, leaking fluid, or bleeding
  • Increased pelvic pressure or the feeling that the baby is pushing down
  • Symptoms similar to those of a menstrual period such as low, dull backache or cramps
  • Abdominal cramping with or without diarrhea
preterm infant receiving treatment

Improving Outcomes for Premature Babies

Once a baby has been born prematurely, there are a number of variables at play to determine how they have been impacted and what can be done to help. “In general, the earlier a baby is born, the risk of long-term complications is increased. The severity and complexity of possible complications are also increased as earlier gestational age and birth weight decreases. Having genetic abnormalities or other physical malformations such as heart defects can also lead to prolonged medical concerns throughout life,” says Dr. Sherrow. Luckily, medicine is continuing to evolve to address these complications. Dr. Sherrow explains, “Advances in incubators, breathing machines, antibiotic use, the benefits of breast milk, and neonatal physical therapy are just a few of these improvements. All of these modalities have helped save babies while improving their quality of life.”

Picture of Nicholas Sherrow, MD

Nicholas Sherrow, MD

Neonatologist, Hamilton Medical Center

Get access to the next issue before it hits the stands!