Humana HealthBeat Transcript Archive

Preterm birth can put infants at significant risk for illness and even death. Ideally, we want to reduce preterm births so that these babies can start out healthy. If we can identify who is at risk, then those moms can take extra precautions. We know, for instance, that moms who have a history of delivery prior to 37 weeks are at an increased risk for early delivery in another pregnancy.

A recent study in the Journal of the American Medical Association showed that among those women whose first pregnancy ended in a preterm delivery, almost 20% of white women and 26% percent of African American women had a preterm delivery in their second pregnancy. The good news here is that most women went on to have a full term delivery.

The study also showed that certain women had a higher risk than others. For example, women who delivered prior to 32 weeks were at higher risk of another preterm delivery. The researchers also found that girls younger than 18 years at the time of their second delivery were at more risk for very early delivery.

Vaginal infection has also been considered a risk factor for preterm births. Previous studies have indicated that antibiotic treatment could reduce the chance of early delivery in women who had given birth prematurely in the past. A current study published in the New England Journal of Medicine found that such treatment had no effect on the delivery, even if it was successful in getting rid of the infection.

This issue remains somewhat controversial. An editorial in the same journal actually disagreed with the study's conclusion, partly because of the timing of therapy chosen. Currently, the Centers for Disease Control, or CDC, advises that women with symptoms of vaginal infection during pregnancy be treated. The CDC guidelines also recommend that pregnant women with a history of preterm delivery be screened for infection, even if they don't have symptoms, and be treated if infection is found.

March 24
Preterm Labor
	Preterm birth can put infants at significant risk for illness and even death. Ideally, we want to reduce preterm births so that these babies can start out healthy. If we can identify who is at risk, then those moms can take extra precautions. We know, for instance, that moms who have a history of delivery prior to 37 weeks are at an increased risk for early delivery in another pregnancy. A recent study in the Journal of the American Medical Association showed that among those women whose first pregnancy ended in a preterm delivery, almost 20% of white women and 26% percent of African American women had a preterm delivery in their second pregnancy. The good news here is that most women went on to have a full term delivery. The study also showed that certain women had a higher risk than others. For example, women who delivered prior to 32 weeks were at higher risk of another preterm delivery. The researchers also found that girls younger than 18 years at the time of their second delivery were at more risk for very early delivery. Vaginal infection has also been considered a risk factor for preterm births. Previous studies have indicated that antibiotic treatment could reduce the chance of early delivery in women who had given birth prematurely in the past. A current study published in the New England Journal of Medicine found that such treatment had no effect on the delivery, even if it was successful in getting rid of the infection. This issue remains somewhat controversial. An editorial in the same journal actually disagreed with the study's conclusion, partly because of the timing of therapy chosen. Currently, the Centers for Disease Control, or CDC, advises that women with symptoms of vaginal infection during pregnancy be treated. The CDC guidelines also recommend that pregnant women with a history of preterm delivery be screened for infection, even if they don't have symptoms, and be treated if infection is found.

	What are the other risk factors for preterm delivery? Smoking, alcohol use, and substance abuse More than one fetus (multiple gestation) Infection of the uterus, cervix or urinary tract Abnormality of the uterus including large fibroids Cervix that dilates without signs of labor (incompetent cervix) Chronic disease, such as high blood pressure or diabetes Abnormal fetus Too much amniotic fluid (poyhydraminios) Malnutrition What are the signs of early labor? Cramping Regular contractions of the uterus Low, dull back pain Fluid discharge from the vagina References and Resources: Healthly Start National Resource Center www.healthystart.net March of Dimes www.modimes.org