According to the latest data from the National Center for Health Statistics
babies born prematurely has risen to more than 12.5%, the highest level
in two decades, and a more than 30% increase since 1981. In 2004, more
than half a million babies were born prematurely in the United States.
Babies born prematurely have less developed organs than full-term babies
and are more likely to face serious multiple health problems following
delivery. Premature babies often require extensive and expensive stays
in a neonatal intensive care units, which has specialized medical staff
and equipment. Finally, prematurity is the leading cause of newborn death–accounting
for 25% of deaths in the first month of life.
Premature babies who survive may suffer lifelong consequences, including
cerebral palsy, mental retardation, chronic lung disease, vision and hearing
loss. While many of the underlying causes of
preterm birth are not well known, the three risk factors most consistently identified
by experts are: (1) multiple births–increased due to infertility
treatments, (2) uterine and/or cervical abnormalities, and most importantly
(3) a woman’s past history of preterm delivery. Other possible risk
factors may include: chronic health problems, certain infections during
pregnancy; and cigarette smoking, alcohol or illicit drug use during pregnancy.
Once preterm labor has begun we have minimally effective medications to
stop it long-term. For the highest risk group of women who have a history
of preterm labor weekly progesterone injections are now routinely administered
prophylacticly beginning in the mid trimester.
While addressing socioeconomic issues can influences preterm delivery rates
in high risk groups such as poor African American women, it is complex
and requires extensive resources. In the recent FASTER trial women who
reported taking folate supplementation for 1 year or more had a 70% decreased
risk for preterm birth between 20 and 28 weeks of gestation, and a 50%
decrease in risk of delivering between 28 and 32 weeks of gestation.
Nevertheless it seems wise for women even remotely considering pregnancy
or those not using highly effective forms of contraception (e.g. condoms)
to take a daily multivitamin. Folate has already been conclusively shown
to reduce some neurologic and cardiac birth defects, and perhaps it may
help with the largest cause of newborn complications, preterm delivery.
For more information about
planning your pregnancy please read this brochure in our online women’s health library.