Risk of premature birth: what does it depend on?

by Beatrice Spinelli

Preterm birth, that is, what occurs before the 37th week of gestation, is one of the most serious complications that can arise in pregnancy and can seriously jeopardize the health of the baby. Preterm birth does not involve details risks for the mother while it can lead to risks for the fetus in relation to the gestational period in particular when the latter is less than 34 weeks; vice versa, delivery after the 36th week is considered safe enough for the fetus as long as its development is regular and there are no other concomitant pathologies.

READ MORE: Predict premature birth

However, it is one a real pathology that affects 5-10% of pregnant women and is associated with a high infant mortality, just think that about 75% of perinatal deaths occur in premature babies. But even in those who survive the clinical consequences can be very serious: la respiratory distress syndrome it is perhaps the most serious and occurs due to the incomplete development of the lungs. Other consequences may be: cerebral hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, infections of the arterial duct. In the long term, the most feared risks of prematurity are cerebral palsy, mental retardation with learning problems, retinopathy and sensorineural deficits (deafness, blindness).

The causes of preterm birth are not always well identifiable but it seems that it may depend on particular health conditions of the future mother, on factors attributable to previous pregnancies or on factors directly related to the pregnancy in progress (Read). Here are the different risk factors in detail:

Maternal risk factors:

      Age under 18 or over 40;
      ·         primiparità;
      · Pre-pregnancy weight less than 50 kg;
      Low weight gain;
      · smoke;
      Taking drugs and alcohol (Read)
      Poor antenatal care;
      Heavy or stressful work activity;
      Psychological stress (LAWS);
      · Low socio-economic level;
      ·         anemia;
      Acute or chronic diseases

ALSO READ: Premature birth and respiratory distress syndrome

  Obstetric risk factors:

· Previous miscarriage in the second trimester;

Previous preterm birth;

Previous blood loss;

Cervical or uterine anomalies (fibroids, malformations).


Risk factors attributable to ongoing pregnancy:

· Twin pregnancy;

· gesturesi;

· Fetal malformations;

· Fetal growth retardation;

· Blood loss;

Infections of the genital tract;

· Onset of uterine contractions.

In the vast majority of cases, preterm birth is associated with premature rupture of membranes (Read) and / or infections of the cervix or vagina. This occurs because the passage of bacteria or viruses (especially neisseria gonorrhea, ß haemolytic streptococcus, bacterial vaginosis, mycoplasma-ureaplasma, chlamydia Tracomatis, anaerobes) beyond the cervical barrier can cause an inflammatory reaction capable of causing rupture of the membranes, dilatation (Read) cervical and uterine contractions.

The threat of preterm labor it can manifest itself with the appearance of fixed or intermittent cramps similar to menstrual pain in the suprapubic area or with the actual onset of uterine contractions, painful or not, and therefore of labor. In these cases, especially if these symptoms are associated with the presence of one or more risk factors, it is necessary to go to the hospital immediately. Preterm labor takes place similar to that of a full-term birth: regular and painful uterine contractions appear, the cervix changes and the membranes rupture. The afterbirth, i.e. the expulsion of the placenta (Read), as well as postpartum and puerperium occur as in term birth.
It must be said that the labor of preterm birth can have a shorter course than the labor of a full term birth and the symptoms that precede it can be very few. However, it is very difficult to distinguish between the threat of preterm labor and ongoing preterm birth.

ALSO READ: Cerclage of the uterus and premature birth

It can happen in some cases that preterm birth is voluntarily induced for medical reasons, in the event that the health conditions of the mother or the baby (or both) are compromised. Through the ultrasound examination it is possible to predict the risk of preterm birth (Read); women affected by this risk are generally advised to stay at rest. In some cases they are prescribed as a preventive measure tocolytic drugs which inhibit the contractile activity of the uterus. The most effective measure regarding the outcome of a preterm birth is related to the administration of cortisone with the aim of inducing fetal lung maturation between the 24th and 34th week of gestation: these therapies together with the great progress in neonatal care have significantly improved the prognosis of premature babies (GO TO THE FORUM)

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