Expert / 16 November, 2022 / Professor Asma Khalil

What Are The Warning Signs And Risk Factors Of Premature Birth?

The 17^th November marks World Prematurity Day. Professor Asma Khalil, Consultant Obstetrician at The Portland Hospital explains the risks, how to spot the signs, and how to reduce your chances of a premature birth.

Around 60,000 babies are born prematurely in the UK every year, which equates to one in thirteen babies. While some premature babies need no additional neonatal support, others will require a prolonged stay in a neonatal intensive care unit to minimise the risk of serious complications or death.

While modern medicine and new technologies have enabled doctors to give premature babies a hopeful start in life, prematurity is still the leading cause of death in under-fives across the globe.

There are, however, many ways expectant mothers can minimise their risk of a premature birth. They should also know that support and care are at hand should they deliver early.

To help provide some clarity on this topic, Professor Asma Khalil, Consultant Obstetrician at The Portland Hospital, (part of HCA Healthcare UK), discusses everything you need to know about premature births.

What is a premature birth?

A birth is considered premature if it occurs before the 37th week of pregnancy. There are three different categories of premature birth based on gestational age which each carry their own risks and individual needs for specific care.

Babies born before twenty-eight weeks are classed as being extremely preterm, babies born between twenty-eight and thirty-two weeks are very preterm, and babies born between thirty-two to thirty-seven weeks are moderate to late preterm.

Preterm labour can begin anytime between weeks twenty to thirty-seven of pregnancy, compared to the length of normal pregnancy, which is around forty weeks. The final weeks in the womb are crucial for healthy weight gain and the full development of vital organs, such as the brain and the lungs, so babies born prematurely have increased risk of long-term health conditions or physical disabilities.

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What causes premature birth?

There are many different reasons why a baby may be born prematurely. However, some of the most common medical reasons include infection either in the uterus or around the body,  weak neck of the womb, uterine bleeding, high blood pressure, and long-term health conditions such as heart disease or kidney disease.

Women who are having a multiple pregnancy also carry a greater risk of going into labour prematurely. The average length of a pregnancy for twins is thirty-seven weeks compared to the usual forty weeks, this shrinks again for triplets, where the average length of pregnancy in the UK is thirty-three weeks.

Sometimes the exact cause of a premature birth is unknown. However, this is rare so it’s important mums-to-be get checked out by their GP as soon as possible to mitigate any risks if they think something is wrong.

What are the symptoms of premature labour?

There are several symptoms which could indicate premature labour so it’s important to monitor every day of the pregnancy to spot any unusual changes. Women may suffer from strong period-like cramps or a feeling of intense pressure in their pelvis. These symptoms may also be accompanied by nausea and diarrhoea, a frequent need to urinate, an increase in vaginal discharge or a slow trickle or gush of clear fluid from the vagina.

If any of these symptoms are present, it is important expectant mothers contact their hospital or midwife as soon as possible, as they could be in labour.

Can you reduce your risk of a premature birth?

Some risk factors, such as a premature birth in a previous pregnancy, cannot be changed so instead mothers should speak to their midwife or hospital regularly to monitor their pregnancy. Prenatal appointments are beneficial as they allow healthcare providers to monitor for any symptoms which could suggest an underlying health problem, so they are found and treated quickly. If there is a higher risk of preterm labour following complications from a previous pregnancy, it is recommended to visit for prenatal appointments more regularly.

One of the most important things people can do to reduce their risk of a premature birth is to quit smoking. Smoking while pregnant has been linked to premature birth and can cause serious harm to the baby. The more cigarettes people smoke, the more likely they are to give birth before their baby is full-term. If someone wants to give up smoking while pregnant, they should speak to their healthcare provider for specialist advice so they can be sure they are getting the support they need to benefit their health and their baby.

Dangers of drinking alcohol

Drinking alcohol is also a known risk factor for causing premature birth. Giving up alcohol completely is the safest option for mother and child, however, reducing to a small drink on rare occasions also has benefits compared to continuing to drink regularly.

Taking recreational drugs can also cause premature delivery and harm the baby. Substances such as cannabis, heroin, and cocaine all contain chemical components that are dangerous for both the mother and her baby, while their mood-altering effects can cause parents to make lifestyle choices which can increase the risk of a premature birth. Giving up these harmful substances will reduce the risk of premature labour and will also prevent the new-born from developing withdrawal symptoms after delivery when the drug is no longer in their system.

Being physically active during pregnancy

Being physically active throughout pregnancy and maintaining a healthy weight have all been proven to help reduce the risk of premature labour. Exercise can reduce the risk of developing health problems such as diabetes or pre-eclampsia, a condition which causes the mother developing high blood pressure during pregnancy, which are all known risk factors for premature birth. Exercise can be as simple as going for a gentle stroll every day or attending an antenatal fitness class to help boost wellbeing and overall health.

Impact of stress

Stress is another common risk factor for premature birth. While short-term stress such as a brief argument is usually not enough to induce labour, chronic stress can cause long-term changes in the body’s hormone levels, vascular systems and immune systems which can influence labour to start before the baby is full-term. Any expectant mothers suffering from chronic stress should speak to their GP as soon as possible to protect their mental health and their child’s health.

Article by Professor Asma Khalil, Consultant Obstetrician at The Portland Hospital, (part of HCA Healthcare UK).

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