Approximately 12% of babies born in the United States this year will be born preterm. Unfortunately, this rate has increased over the last few decades (up from about 9.4% in 1981).
Complications from prematurity account for the majority of neonatal deaths in our country every year. Babies born preterm face multiple potential health problems including respiratory, neurological, gastrointestinal, hearing, visual, behavioral and cognitive problems. Billions of dollars are spent annually on moms and babies who have been affected by preterm birth. In the U.S., 35% of health care spending for infants is used for treating children affected by prematurity.
The exact cause of preterm labor is rarely found. Although risk factors such as substance abuse, certain infections, and family history of preterm delivery may be present in some cases, the vast majority of preterm deliveries occur with no identifiable cause. Researchers continue to search for answers to the cause of preterm labor. Although we have not been able to determine "why", we have made some progress in identifying women who are either at high risk for preterm delivery, or are showing signs of impending early labor. The use of vaginal ultrasound to measure a pregnant mom's cervical length now allows us to identify women who are at the highest risk for early delivery. Also, the use of a fetal fibronectin test has helped physicians to determine which symptomatic patients are at highest risk of delivering early.
The problem of not having effective treatments when preterm labor occurs is equally as frustrating as the problem of not knowing "why." Tocolytics, drugs used to relax the uterus and stop contractions, have never been shown to prolong pregnancy once early labor begins. There is not a tocolytic available today that has proven helpful in prolonging a woman's pregnancy after preterm labor begins. However,administering corticosteroids to mothers prior to early delivery has resulted in a decline in certain health problems for premature babies, and advancements in the medicine and technology in the Neonatal Intensive Care Units has resulted in improved outcomes for these babies.
So if we don't know the reason "why", and we don't have any effective treatments to stop early labor, then what CAN we do?? We should continue to encourage all potential mothers to be as healthy as possible both prior to getting pregnant as well as during their pregnancy. We should encourage exercise and healthy nutrition, as well as proper management of preexisting health problems and making sure that any needed medications are safe during pregnancy. Smoking cessation and avoidance of alcohol and drugs should be stressed to potential mothers. We should strive to identify potential mothers who DO have risk factors for early delivery, such as family history of preterm delivery. Early and thorough prenatal care should be stressed for anyone considering pregnancy.
Lastly, we must continue to support and help fund research to help find the causes of preterm labor and to develop better treatment for mothers affected. Organizations such as the March of Dimes have made it their mission to not only raise awareness of this monumental health concern, but to help fund the research which will one day result in treatments that will help our preterm delivery rates decline.