How to Prevent Preterm Labor

According to a preterm birth report released by WHO, there are 15 million preterm births annually around the world; that's about one in ten. Preterm labor has been the leading cause of neonatal death. Every year, one million babies die from premature birth complications.

What are the causes of preterm labor? Is there anything we can do to prevent it? Is it possible to know whether we are at a higher risk? Read our Q&A with Beijing United Family Hospital (BJU) Obstetrician and Gynecologist Dalice Marriott to learn more.

What is the definition of preterm labor?

Anything past 37 weeks of pregnancy is considered a full-term pregnancy, and anything before that is considered preterm. The miscarriage definition is different, though. In China, a miscarriage is anything before 28 weeks. But in the US, the bar is 20 weeks.

What are the possible causes of preterm labor?

For someone who has had an early delivery before, there is an increased risk (approximately 30 percent) that she will have another early delivery for her second child. Sometimes, the reason for preterm labor is genetic. The exact cause may not be known. Other factors that can increase the likelihood of preterm labor include inflammation (pollution increases inflammation in the body and it may be linked with an increased risk for preterm labor), multiple gestations, too much water in the uterus (around the baby), and when the size of the baby is too big.

Q3: Why is preterm labor hard to diagnose?

Signs of preterm labor can be very vague and similar to normal pregnancy, and differ from person to person. That’s why it can be hard to diagnose. It can present with back pain, which is quite normal for all pregnant women. So, if you are really worried, come to the hospital for evaluation because this is not something that can be diagnosed over the phone.

The definition of labor is contractions that cause the cervix to open and/or shorten. Ultrasound can help to check if it is real labor, but what we have to often do is to look at the mother over time and see if her contractions are changing her cervix. Is her cervix opening? Is her cervix shortening?

Be careful when you experience cramping or tightening that don’t go away or are even getting worse after rest because they could be reasons for you to come to the hospital for further checkups.

For someone who has never been pregnant before, it is hard to predict whether she is likely to have a preterm labor or not. But there is still something we can look at. For example, if the cervix at 20 weeks appears very short or is opening under the ultrasound, this could be a sign for possible preterm labor. What we can do about that is giving her vaginal progesterone after certain evaluations, a medicine that help decreases the risk.

Q4: How is bleeding related to preterm?

Bleeding can be a sign of preterm labor. The source of the bleeding can be the cervix or the placenta. Bleeding from the placenta can cause irritation to the uterus and lead to contractions. If you bleed over two trimesters or more, you are more likely to have an early delivery. (First trimester: 0-14 weeks, second trimester: 14-28 weeks, third trimester: 28 weeks-delivery)  

Q5: How can we better avoid preterm labor?

Control your weight during pregnancy; you want to gain weight, but not too much weight, nor too little weight.

Get to know what are your distinguished “norms” during pregnancy, how the cramping works, how the baby moves, what your vaginal discharge should look like, etc. And be aware of changes from these norms.

Take notes of the changes, for example, a funny pain, when does it happen? Where is it? How does it feel? Does it go away? As these are the questions doctors would want to know when you get to the hospital.

Dr. Dalice Marriott is BJU's Chair of Obstetrics. She is board-certified by the American Board of Obstetrics and Gynecology and is a member of the American Medical Association and an American Congress of Obstetrics and Gynecology Fellow. If you have more questions or concerns about preterm labor, call our 24-hour hotline on 4008 919191 to schedule an appointment with Dr. Dalice. 

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