What are the causes of Preterm Labor?

Causes of Preterm Labor

Labor which occurs before the 37th week of pregnancy is known as "preterm labor." A "normal" pregnancy lasts about 40 weeks. Approximately 12% of births in the U.S. are preterm. Preterm babies are at a greater risk of hospitalization, having neurological, digestive, breathing, or other long-term health problems and of dying as compared to babies born after the 37th week. These babies are also at risk of delayed development and learning disabilities.

Nearly 8% of all deliveries are preterm. Premature labor is responsible for around 75% of stillbirths and deaths of babies in first 7 days of life. Despite the improved technology and skill of neonatal pediatricians, approximately 10% of the babies who survive (generally the most immature) suffer some degree of lasting mental or physical handicap.

The causes of preterm labor are not readily identifiable, but there are certain risk factors which can cause spontaneous preterm birth. These include:

  • Previous preterm delivery
  • Preterm premature rupture of the membranes
  • Pregnant with twins, triplets or more
  • Maternal history of one or more spontaneous 2nd trimester miscarriages
  • Smoking
  • Illicit drug use
  • Alcohol use
  • Lack of prenatal care
  • Stress
  • Long periods of standing
  • Domestic violence
  • Myomata
  • Uterine septum
  • Bicornuate uterus
  • Cervical incompetence
  • Exposure to diethylstilbestrol (DES)
  • Certain infections
  • Intrauterine fetal death
  • Intrauterine growth retardation
  • Abnormal placenta
  • Presence of a retained IUD
  • Clotting disorders
  • Obesity
  • Being underweight before pregnancy
  • Short time between the pregnancies (less than six to nine months between birth and commencement of next pregnancy)
  • Diabetes

There are treatments that can help stop preterm labor if they are given early enough. There are some other medications which can be given 24 hours before birth for accelerating the baby's lung and brain maturity, decreasing some of the long-term risks. It is important that you receive quick and capable medical care if you are experiencing preterm labor.

Symptoms of preterm labor include:

  • Contractions every 10 minutes or more frequently
  • Change in vaginal discharge
  • Pelvic pressure-the feeling that the baby is pushing down
  • Low, dull backache
  • Cramps which feel like menstrual cramps
  • Abdominal cramps with or without diarrhea

Induction of Premature Labor

While it is usually desirable for a pregnancy to reach its full term, there are few circumstances in which obstetricians must induce preterm delivery for the safety of the mother and/or the child. One of the following may demand the induction of preterm labor:

  • Severe hypertension or eclampsia, or a seizure or coma in a woman with pre-eclampsia; a condition that occurs during the second half of pregnancy and is characterized by swelling, high blood pressure, and large amounts of protein in the urine.

  • If the amniotic sac ruptures prior to 37th week of pregnancy, it is a condition known as preterm premature rupture of membranes (PPROM). The decision to induce preterm labor depends on the gestational age of the fetus and presence of an infection.

  • Fetal stress, where in evidence of poor growth as well as lack of oxygen is discovered.

Usually, every effort is made to assure that a baby is as mature as possible prior to the delivery. In certain cases, however, even a very premature baby is better served by Neonatal Intensive Care Unit (NICU) facilities in comparison to continued dependency on a less-than-healthy uterine environment.

       
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