The chances of a pregnant woman in the United States having a healthy, normal pregnancy and childbirth are good—but not nearly as good as they used to be. Preterm birth, defined as occurring three weeks before the due date, now occurs in one out of every eight births in the United States. This is an increase of 30 percent since 1981. Every year, nearly 500,000 infants are born premature.
While improvements in the treatment of preterm infants in neonatal intensive care units have helped to greatly improve their survival, these infants remain vulnerable to many complications. These may include respiratory, gastrointestinal, immune system, central nervous system, hearing, and vision problems. Longer-term problems may include cerebral palsy, mental retardation, visual and hearing impairments, behavior and social-emotional concerns, learning difficulties, and poor health and growth. In general, the more immature the infant, the greater the degree of life support that is needed and the greater the risk of serious and long-term complications.
Who is at risk?
Researchers have identified some risk factors for premature birth, but still cannot predict which women will give birth too early. Having a risk factor does not mean a women will have preterm labor or birth; it means she is more likely to have preterm birth than other women. Three groups of women are at greatest risk:
• Women who have had a previous preterm birth
• Women who are pregnant with twins, triplets or more
• Women with certain uterine or cervical abnormalities
Women younger than age 20 or older than 35 are at greater risk, as well as women who become pregnant less than one year after giving birth. Certain medical conditions during pregnancy may play a role. These include:
• Obesity
• Diabetes
• High blood pressure
• Certain birth defects in the baby
• Being underweight before pregnancy
• Urinary tract infections, vaginal infections, sexually transmitted infections and possibly other infections
• Clotting disorders
• In vitro fertilization
Some studies have found that these lifestyle factors may put a woman at greater risk of preterm labor:
• Late or no prenatal care
• Smoking
• Drinking alcohol
• Using illegal drugs
• Domestic violence, including physical, sexual or emotional abuse
• Lack of social support
• Stress
• Long working hours with long periods of standing
November is Prematurity Awareness Month, a time to educate the public about this increasingly common, costly and serious public health problem. Prematurity is the number one cause of death for infants. The lifetime consequences for those who survive can be significant, and they often require a broad range of services and social supports. For this reason, prematurity is a serious problem not only for the individual families who are directly affected, but also for society as a whole.
For more information about prematurity and how you can help join the fight to prevent it, log on to marchofdimes.com/prematurity.
