Understanding preterm birth

In my practice, it is not uncommon for me to meet with women who are at risk of delivering preterm (prior to 37 weeks gestation).

In Australia, around eight per cent of babies are born preterm. Whilst the majority of these babies are born between 32 and 36 weeks gestation, almost two per cent are born prior to 32 weeks gestation.

During the last stages of pregnancy, a developing baby undergoes important growth. In the final weeks many organs are still developing, so to be born prematurely means that there are often complications. As a result preterm babies require specialised care. This care will vary depending on how preterm they are and their individual condition or circumstance.

However, it is fair to say that in many cases, the earlier the birth, the more likely for serious complications for both mum and baby.

You may be at higher risk of a preterm birth if you have:

• a history of preterm birth
• uterine abnormalities
• had prior cervical surgery
• a low body mass index (BMI) at the beginning of your pregnancy
• a multiple pregnancy (twins, triplets etc.)
• preeclampsia
• chronic conditions such as diabetes and high blood pressure
• fetal growth restriction
• a history of smoking.

If you are at risk of delivering preterm, your obstetrician may advise hospital admission and/or bed rest. While long periods of bed rest can be unpleasant, it is important to remember that being in hospital allows for close observation of both you and your baby’s condition. Being close to obstetric and neonatal care is important if labour or an emergency situation arises.

Fortunately there are a range of tests in early pregnancy that make it possible to predict a number of severe conditions that complicate pregnancies. These tests can highlight pregnancies at risk so that we can continue to monitor and manage the pregnancy appropriately. For certain conditions evidence based interventions are also now available to help reduce the risk or severity of preterm birth.

Hopefully, because we can perform these predictive tests and administer appropriate interventions and treatments, we can reduce the incidence of preterm birth and subsequently improve the outcomes for babies born prematurely.

If you are concerned that you may be at higher risk of a preterm birth, or would like to know more about the predictive tests, please speak to your obstetrician or midwife.

Maternal Fetal Medicine

If you are considered to be at risk of delivering preterm, your obstetrician may refer to you the Mater Centre for Maternal Fetal Medicine. Located within Mater Mothers’ Hospitals in South Brisbane, the centre has a strong history of providing quality and compassionate care to women and babies with complex complications in pregnancy.