10 Ways to Prevent Preterm Labor

The frightening story of Kim Cowan’s delivery at 31 weeks, in a Parenting.com article called Can You Prevent Pre-Term Labor? is a story that is being told more frequently today, due to the “widened use of fertility treatments (and the related rise in multiple births) and the older age at which women today begin having children.” Preterm birth (one that occurs before 37 weeks of pregnancy) is the number one cause of neonatal death in the first month of life, and it can trigger health problems such as developmental delays, chronic lung disease, and cerebral palsy. It affects about 480,000 babies annually, or one in eight live births, according to the National Center for Health Statistics.

As such, it is not something to be taken lightly, and any steps that can reduce the risks should be carefully considered. Although the effectiveness of common treatments for preterm labor are unknown, new research is beginning to hint at both the causes of preterm labor and ways to prevent it.

Here are 10 ways to reduce your risk of pre-term labor from Parenting.com.

1. Get early prenatal care. See your health care practitioner as soon as you know you’re pregnant, or if you are trying to get pregnant. Your doctor can advise you on how to eat right, gain weight properly, and screen you for infections that can harm your pregnancy. He can also give you a prescription for a prenatal vitamin, which contains essential nutrients including folic acid, a key B vitamin that can prevent neural-tube birth defects like spina bifida (an opening in the spine). New research also suggests that folic acid may also lower the risk of placental abruption (when the placenta separates from the uterine wall) and preeclampsia (high blood pressure during pregnancy), two conditions that are responsible for about 20 percent of early deliveries. Read more here.

2. Know your risks. Certain pregnant women are more likely to deliver early. Risk factors include a prior early delivery; smoking or illegal drug use; high blood pressure or diabetes; carrying multiple fetuses, such as twins; a uterine infection during pregnancy; an age of 35 or older; pregnancy complications such as preeclampsia; being over- or underweight; and being African-American. Talk to your doctor about ways to minimize these risks, such as improving your diet and exercise habits, or treating a uterine infection. Read more here.

3. Get tested. Uterine infections that can begin in the lower genital tract may be responsible for up to half of all preterm births, particularly those that occur before 30 weeks’ gestation. It’s been known for years that infections and sexually transmitted diseases such as gonorrhea and chlamydia increase preterm birth risk. But doctors are now looking at other suspect infections like bacterial vaginosis (BV), a condition that can cause an unpleasant odor and gray discharge. It’s more common in African-American women who also have higher rates of preterm birth. Treating BV in high-risk women appears to reduce their rates of early delivery, but BV doesn’t always cause symptoms. Recognizing and treating infections early on may hold the key to lowering preterm birth rates as much as 30 percent. Gen screened for other risky conditions including periodontal (gum) disease, untreated urinary-tract infections, and trichomoniasis. It can improve your odds of having a healthy baby. Read more here.

4. Visit the dentist. Regular cleanings may help prevent preterm delivery. It’s believed that the same chain of events initiated by a uterine infection can occur if you have a dental condition such as periodontal (gum) disease. Hormone changes that occur during pregnancy make women more susceptible to gingivitis — a condition marked by swollen, red gums that are more sensitive to the negative effects of plaque — which can lead to gum disease. Visit the dentist before or early in pregnancy to be checked for gum disease, maintain regular dental checkups, and brush and floss after meals. Read more here.

5. Watch your weight. The average woman should put on 25 to 35 pounds during pregnancy. Gain too much and you up your odds of complications like gestational diabetes and preeclampsia, which increase preterm labor risk. Overweight and obese women are recommended to gain less weight (usually 15 to 25 pounds) and follow a nutritious diet and safe exercise to lower your risk. Underweight women with a body mass index (BMI) under 20 (a healthy BMI is 20 to 25) are less likely to carry their baby to term. These women may be prone to nutritional deficiencies that adversely affect the fetal environment. You may have your doctor recommend a nutritionist for help with proper diet and weight gain. Read more here.

6. Eat right. A nutritious diet during pregnancy can be vital to healthy fetal development. That means whole-wheat carbs, healthy sources of protein and dairy, and an abundance of fruits and vegetables. Recent studies suggest that women who have higher levels of omega-3 fatty acids (found in such fish as salmon) have lower rates of preterm birth, so it’s worth including them in your diet. Other preliminary studies suggest that calcium and vitamin C may help prevent preterm labor. It’s recommended that pregnant women consume 1,200 milligrams (mg) of calcium per day (the equivalent of four 8-ounce glasses of skim milk) and 85 mg of vitamin C, roughly the amount in one orange. Read more here.

7. Excercize. Regular exercise can reduce your risk of developing gestational diabetes, and recent research suggests that it may help prevent preeclampsia as well. Women who walked for exercise during the first 20 weeks of pregnancy lowered their risk of preeclampsia by a third. Severe chronic stress may kick-start labor, and exercise can help you relax. Talk to your doctor about pregnancy-safe workouts such as swimming, walking, and yoga are good options. Of course, you must stop smoking, drinking alcohol, and using unprescribed drugs, all of which drastically increase your odds of early delivery. Read more here.

8. Check medications. Pregnant women who are depressed or anxious have a twofold increase of preterm birth, according to Dr. Lockwood, so treatment is crucial. One recent study, however, suggests that a class of antidepressants used to treat these conditions, known as selective serotonin reuptake inhibitors (SSRIs), may be associated with a slightly higher risk of preterm delivery. Another option, tricyclic antidepressants, did not show this association. (Neither type of medication has been shown to cause birth defects.) However, it’s important to remember that many women have used SSRIs (such as Prozac and Paxil) safely during pregnancy, and the benefits of treating depression often outweigh any risks. Consult your doctor if you feel you should consider switching medication. Read more here.

9. Talk to your doctor if you’ve had a prior preterm birth. A recent groundbreaking study found that a progesterone-like hormone reduced the risk of preterm birth by 34 percent in women who had a prior early delivery. It’s not clear why the hormone helps, but it may be because it’s a muscle relaxant that inhibits contractions and reduces inflammation. Since the drug is widely available, inexpensive, and considered safe for pregnant women, doctors could begin prescribing it now, says Dr. Meis, who uses it in his clinic. If you had a prior preterm birth, you can discuss these findings with your doctor. Your doctor may also recommend that you use a condom during sex, since semen contains prostaglandins, the chemicals that initiate contractions.

10. Recognize the signs of early labor. Although little can be done to reverse the course of preterm labor once it’s started, delivery can usually be delayed for a few days to a week using tocolytics, drugs that suppress contractions. During this critical window, a doctor can administer corticosteroids, which can improve fetal health by speeding up lung maturation. (Without treatment, a preemie may suffer from respiratory distress syndrome, a breathing complication which can lead to health problems and even death.) Delaying labor also allows time to transfer a woman to a hospital with a more sophisticated NICU.

Recognizing the signs of preterm labor

It’s important to recognize the signs of preterm labor, even if you don’t think you’re at risk. According to the March of Dimes, they include:

  • contractions that occur every ten minutes or more

  • fluid leaking from your vagina

  • pelvic pressure

  • lower back pain

  • menstrual-like cramps

  • abdominal cramps that begin in the back and move to the front.

False labor (also known as Braxton Hicks contractions) may stop when you change position, is often weak, and is usually felt only in the front. If you’re not sure it’s the real thing, call your doctor right away.It’s essential to remember that a full 80 percent of women who have symptoms of preterm labor will not deliver early, and the vast majority of pregnancies result in babies who are born healthy and full-term. While medical strides in preventing and reversing the course of preterm labor have been slow, our ability to care for premature babies has skyrocketed. Between 90 and 95 percent of babies born after 30 weeks’ gestation survive, with most growing up to be healthy adults.

Photo: nih.gov

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