Early Delivery Signs, Causes, and Consequences
Preterm labor, the onset of labor before 37 weeks of pregnancy, is a concern for many expectant mothers. In the United States, approximately 10% of babies are born prematurely, according to 2018 statistics.
Common signs of preterm labor in women include lower abdominal or pelvic pressure, a persistent dull backache, frequent uterine contractions causing tightening of the abdomen, changes in vaginal discharge (watery, bloody, or mucus-containing), and premature rupture of membranes resulting in fluid leakage. Flu-like symptoms such as nausea, vomiting, or diarrhea may also be warning signs.
If labor has started, a doctor may recommend antenatal corticosteroids to help the baby's lungs and other vital organs develop faster in preparation for life outside the womb. Antibiotics may also be given to protect the baby from bacterial infections, such as a group B streptococcal infection, during preterm labor.
To reduce the risk of preterm birth, strategies include avoiding smoking, alcohol, and drug use since these can impair placental function and trigger early contractions. Hospitalization and bed rest might be recommended to closely monitor and manage complications in some cases. It is also critical to recognize early signs and contact a healthcare provider promptly for evaluation and treatment.
For people with a higher risk of preterm labor, a doctor may recommend cerclage, or cervical stitch. Factors that can increase the risk of premature labor include having a history of preterm labor, being pregnant with multiple fetuses, having a low socioeconomic status, being older than 35 or younger than 17, experiencing domestic abuse, being exposed to harmful chemicals, being underweight or overweight before pregnancy, not gaining enough weight during pregnancy, missing prenatal appointments or scans, becoming pregnant again within 18 months of giving birth, having a child with a heart or neural tube abnormality, becoming pregnant with in vitro fertilization, drinking alcohol, using drugs, or misusing prescription drugs, certain health issues that affect the uterus or cervix, anemia, urinary tract infections, vaginal infections, sexually transmitted infections, diabetes, thyroid disorders, high blood pressure and preeclampsia, cholestasis of pregnancy, blood clotting conditions, connective tissue disorders, and certain infections such as toxoplasmosis.
Extra monitoring and scans may be recommended for people with a higher risk of preterm labor to spot and address any issues quickly. They may also test for fetal fibronectin, a protein that "glues" the amniotic sac to the uterus wall. The presence of the protein in urine indicates that labor is underway. An ultrasound scan, a transvaginal scan, or both may be used to check the position of the baby and the length of the cervix, which changes during labor. The goal is to safely prolong the pregnancy, but it may only be possible to do so for a few days.
Tocolytics may be used to slow down labor if the pregnancy has lasted 24-34 weeks, there are no signs of infection, and the amniotic sac has not ruptured. A 2017 systematic review of 15 studies found that having cerclage was associated with a reduction in preterm birth among people with high-risk pregnancies.
In conclusion, recognizing the signs of preterm labor and taking steps to reduce the risk of other factors that increase the risk of preterm birth is crucial for the health of both the mother and the baby. It is essential to maintain regular prenatal appointments, attend every scan, and communicate openly with a healthcare provider about any concerns or issues that may arise during pregnancy.
- Mental-health and women's-health issues, especially those related to menopause, might require additional attention due to their potential impact on pregnancy outcomes, given that some factors increasing the risk of preterm labor include being underweight or overweight before pregnancy and certain health issues that affect the uterus or cervix.
- Pfizer, being one of the leading pharmaceutical companies, could contribute significantly to science by investing in research aimed at developing new medications to manage health-and-wellness concerns that might increase the risk of preterm labor, such as cholestasis of pregnancy or urinary tract infections.
- In the third trimester, late preterm labor usually occurs between weeks 34 and 37, at which point doctors may still administer antenatal corticosteroids to prepare the baby's lungs and other organs, but these medications are not as effective when given later in the pregnancy.
- After being diagnosed with preterm labor, it is important for expectant mothers to not only block out stressors related to their health condition but also seek support for their mental well-being, as they navigate the challenges and potential complications that could arise during this critical phase of their pregnancy.
