Reasons you may deliver before your due date

November is National Prematurity Awareness Month, created by the March of Dimes to highlight the types of significant health concerns that arise from preterm birth. When that happens, babies are at higher risk for issues like breathing problems, feeding difficulties, vision and hearing problems, and most tragically, early mortality. Continue reading to learn more.
Premature birth refers to a baby who's born before 37 weeks of pregnancy are completed, the Centers for Disease Control (CDC) notes.

According to the March of Dimes, the U.S. is among the most dangerous developed nations for childbirth, in part due to a health equity gap that puts women and babies of color at greater risk. The CDC reports that preterm birth affects 1 out of every 10 infants born in the U.S., and that the rate among African-American women is about 50 percent higher than among white or Hispanic women.

That's one of the reasons the March of Dimes created Health Equity Week and put it in November, as a way to prompt advocacy and action toward preventing premature births.

Healthcare equity isn't the only concern when it comes to this issue, however. Here are other potential causes of premature birth:

Age of the mother

Teenagers and women over age 35 are more likely than women in their 20s and early 30s to have premature birth. The March of Dimes adds that teen mothers are also at higher risk for having low birthweight babies who may have organs that are not fully developed. That can lead to complications like respiratory and intestinal problems.

Infection that affects the amniotic fluid

Research suggests that when bacteria is present in the uterus during pregnancy, it can lead to an inflammatory response that causes preterm birth as a way to preserve maternal health. In some cases, an infection can lead to a rupture of the amniotic sac—known as "your water broke"—resulting in loss of fluid and the need for an immediate delivery.

Carrying more than one baby

For instance, triplets usually arrive around 34 weeks, and the average weight of those babies is about 4 pounds. That's compared to the average weight of a full-term baby at approximately 7 pounds. Twins, however, usually arrive closer to the 37-week mark and are often closer to the average birth weight.

Use of tobacco, alcohol, or other substances

These can all lead to significantly higher premature birth risk. For instance, the CDC notes that smokers are more likely to give birth earlier, but that quitting during pregnancy may help prevent preterm birth.
Similarly, there's a strong association between maternal alcohol consumption and risk of preterm delivery. Research indicates that heavy drinking during the second and third trimesters was especially problematic—which means if a woman has been drinking during her first trimester when she may not even know she's pregnant, quitting before the second trimester can considerably lower the risk of preterm birth.

Diabetes and high blood pressure

Chronic conditions like hypertension and diabetes can also affect pregnancy in significant ways. Women with diabetes are at increased risk for a condition called polyhydramnios, which is too much amniotic fluid. Much like an infection, this could lead to rupture and the need for labor to begin.With high blood pressure, early delivery may be recommended as a way to prevent health problems for the baby. High blood pressure can narrow blood vessels in the umbilical cord and reduce oxygen and nutrients to the baby as a result.

Low income

Socioeconomic status on its own isn't enough to make preterm birth inevitable—after all, plenty of women in lower income brackets give birth or past their due dates. However, income or economic status can affect healthcare access, which means there may be less opportunity for prenatal care that would boost the chances of a healthy pregnancy and regular delivery.

In general, health during pregnancy plays a role and should be carefully monitored throughout the entire 37 weeks and beyond.

Understanding factors like these is useful not just for clinicians who may treat pregnant women, but also for those trying to get pregnant. Greater awareness—during November and every other month, too—is important for addressing an urgent issue facing mothers, babies, and their families.

For the most up-to-date health and wellness education from Mass General Brigham Health Plan, follow us on social @MGBHealthPlan


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