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Normal pregnancies last for 40 weeks. If labor starts at 37 weeks or earlier, it is considered premature labor. Labor occurs when uterine contractions lead to the thinning and opening of the cervix. Babies born prematurely have a greater chance of several health complications.
Although any baby born preterm is at risk for health problems, the risk increases the earlier the baby is born. For example, babies born between 23 and 28 weeks into pregnancy are considered extremely premature. They are at the greatest risk of complications.
Although the cause of premature labor is not always identified, there are some risk factors that increase the chance of a baby being born early.
Substance abuse and smoking cigarettes increase the chances of premature labor. Mothers who are overweight or underweight prior to pregnancy also carry a higher risk.
All though most women carry their babies to full term, the U.S. Centers for Disease Control and Prevention (CDC) say that premature labor is about 50 percent more common for African-American women than for women of European descent women. The reason for this is not understood and is the focus of research.
Other risk factors include:
If premature labor is suspected, a pelvic exam is performed to determine if the cervix has started to thin and dilate. An ultrasound then checks the position of the baby’s head in the uterus. The baby’s age and weight can also be checked with the ultrasound.
A uterine monitor can determine how strong and frequent contractions are. In some cases, a swab of the vaginal secretions is taken to test for the presence of fetal fibronectin. This is a protein that is secreted during labor.
Symptoms of premature labor include uterine contraction. This may or may not be painful. A backache is also a common symptom of premature labor. Abdominal cramping may also occur. Some women may have diarrhea.
Vaginal discharge may change and include bloody or watery fluid. Not all women who experience premature labor will have their water break. When it does occur, it may be a slow trickle of fluid or a gush.
Treatment for premature labor depends on how far along the pregnancy is. When the baby is near full term it may only be considered slightly premature. In these cases, labor is usually allowed to progress normally.
The health of the mother and baby need to be considered before the decision is made to either allow or stop labor.
To prevent premature birth, bed rest, medication, and fluids are usually advised. Medication usually includes magnesium sulfate, which is given to women who are less than 34 weeks pregnant. The medication is administered to stop contractions. It may also reduce the risk of neurological complications if the baby is born early.
Steroids are sometimes given to women in premature labor. Steroids help the baby’s lungs mature. Tocolytics (labor suppressants) may also be recommended in some circumstances. The medication temporarily stops contractions. Although it can be used only short-term, it may allow time for steroids to be given and improve lung maturity.
Not all women who experience premature labor deliver prematurely. According to the American College of Obstetricians and Gynecologists, premature labor stops on its own in about 30 percent of women. In other instances, premature birth can be stopped with interventions.
When premature labor is not prevented, the prognosis for the baby varies greatly. Some babies born prematurely do not suffer any health complications.
Other babies have serious complications. These include problems with the heart, lungs, gastrointestinal track, and metabolism. Babies born very prematurely are also at risk for bleeding in the brain. Some babies born prematurely may have also long-term health issues. These can include cerebral palsy, learning difficulties, and hearing problems.
Getting proper prenatal care plays an important role in preventing premature delivery. Eating a healthy diet and getting enough of certain nutrients including folic acid and calcium is also importation. Gaining the recommended amount of weight, not smoking, and avoiding the use of illicit drugs or alcohol are also critically important for having a healthy pregnancy, labor, and infant.
Written by: MaryAnn DePietro
Medically reviewed on: Jan 16, 2014: George Krucik, MD, MBA
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