Preterm Birth

What is premature birth?

A preterm, premature or “preemie” baby is a baby born too early, or about three weeks before their due date. A full-term pregnancy (fetal development) lasts about 40 weeks. Preterm birth occurs when a baby is born at 37 weeks or earlier.

Premature or early birth can pose serious health risks to a newborn baby. That’s because many organs like the brain, lungs and liver, are still growing and developing in the final weeks of pregnancy. A premature baby may have trouble staying warm or feeding and may be at risk for developmental delays later in life.

Fortunately, advances in medical technology make it likely that a premature baby can overcome these early obstacles and grow into a healthy child.

What are the different types of premature birth?

Healthcare providers consider a pregnancy to be full term when childbirth occurs at 39 weeks or later. Research shows that infants born after 39 weeks are less likely to spend time in a neonatal intensive care unit (NICU).

When a baby is born after 37 weeks but before 39 weeks, healthcare providers call it early term. This isn’t the same as prematurity.

Deliveries before 37 weeks are considered preterm or premature. Preterm births fall into four categories:

• Late preterm: Born between 34 and 36 weeks. Most premature births occur during this time frame.
• Moderately preterm: Born between 32 and 34 weeks.
• Very preterm: Born before 32 weeks.
• Extremely preterm: Born before 25 weeks.

How common is premature birth?

About 1 out of every 10 births in the U.S. is premature.

Rates of premature birth are increasing as more women become pregnant after age 35 and as assisted reproductive technologies (like IVF) more often result in multiple gestations and higher-risk pregnancies.

What week is preterm birth safe?

Typically, the earlier a baby is born, the higher the risk for health complications. This isn’t always the case, nor does it mean if your baby is born at 39 weeks, there’s no risk of complications. It just means that studies show a baby is more likely to be born healthy when it reaches at least 37 weeks of pregnancy before birth.

What are the most common causes of premature birth?

Premature births can happen suddenly, with no one cause. Sometimes, providers have to induce (start) labor early for medical reasons. Women can also go into premature labor due to:

• Chronic health conditions, such as diabetes or heart disease. Your healthcare provider will help you manage these and other chronic health conditions during pregnancy.
• Placental conditions like placental abruption or placenta previa.
• Preeclampsia.
• Expecting multiples. About 60% of twins and triplets are born prematurely.
• Problems with the uterus or cervix.
• Vaginal bleeding or infections during pregnancy.
• Using substances like drugs and alcohol or smoking during pregnancy.

What are signs that a baby is premature?

There may not be recognizable signs that an infant was born early. But, some of the more common symptoms of premature birth are:

• Low birth weight.
• Breathing difficulties.
• Low body temperature.
• Fine hair (lanugo) covering the baby’s body.
• Feeding difficulties.

What are risk factors for premature birth?

You may be at an increased risk for a premature birth if you:

• Are Black or Hispanic.
• Are expecting multiples (twins, triplets or more).
• Are under the age of 17 or over the age of 35.
• Have a family or personal history of preterm births.
• Smoke, drink alcohol or use other substances while pregnant.
• Are underweight before pregnancy or don’t gain enough weight during pregnancy.

What are health complications of being born premature?

A premature baby doesn’t have enough time to fully develop. This means certain organs and body systems may not be ready to support them in their life outside the uterus. This can cause serious health problems. Preemie babies often need special care in a NICU before they can leave the hospital. After a premature baby is born, a neonatologist evaluates them to determine what type of care they may need.

Some of the most common health conditions that affect premature babies are:

• Anemia, or not having enough healthy red blood cells.
• Apnea of prematurity, or temporary pauses in breathing.
• Bronchopulmonary dysplasia, respiratory distress syndrome or underdeveloped lungs.
• Intraventricular hemorrhage, or bleeding in their brains.
• Newborn jaundice or hyperbilirubinemia, which means there are high levels of bilirubin in their blood.
• Necrotizing enterocolitis, or inflammation of their intestines.
• Neonatal sepsis, or blood infection.
• Patent ductus arteriosus (PDA), or abnormal blood flow in their hearts.
• Retinopathy of prematurity, or underdeveloped blood vessels in their eyes.

Premature babies are also at a higher risk of developmental challenges during childhood. They may have health issues later in life, including:

• Cerebral palsy.
• Hearing and vision problems.
• Learning disabilities.
• Poor growth.
• Problems with communication or social development.

What health risks does premature birth pose to the pregnant woman?

A baby born prematurely can have a huge emotional impact on the entire family. Women who go into preterm labor are more likely to have:

• Anxiety.
• Postpartum depression.
• Post-traumatic stress disorder (PTSD).
• Problems bonding with their baby.

Do premature babies need special care?

Sometimes. Only your baby’s healthcare provider can tell you what kind of care or monitoring they need or when it’s safe for your baby to go home. Sometimes you can bring medical equipment home and care for your baby on your own.

How is prematurity treated?

Preterm infants often need specialized medical care in a NICU. This is a specific part of the hospital for babies that need extra care and medical attention. Some babies stay in the NICU for weeks or months.

Preterm infants often need help with:

• Breathing.
• Feeding.
• Gaining weight.
• Maintaining their own body temperatures.

Does preterm labor always cause preterm birth?

Sometimes, preterm labor stops and doesn’t result in birth. Labor may stop on its own, or with the right treatments.

If you go into preterm labor, your healthcare provider may recommend certain medications to stop or delay labor. If those medications don’t work, other medications may help prepare the baby for birth and prevent some medical complications.

Can you prevent preterm birth?

There’s no single way to prevent premature birth, but you can take these steps to reduce your risk of premature labor:

• Avoid tobacco, alcohol or other substances while pregnant.
• Eat nutritious, well-balanced foods during pregnancy.
• Start prenatal care in the first trimester so that your provider can identify health risks as early as possible.
• Discuss how to manage health conditions like diabetes and high blood pressure with your provider. Unmanaged health conditions can lead to preterm birth and other complications.
• Attend all of your prenatal care appointments.
• Reduce your stress level.
• Wait at least 18 months between pregnancies.

Can premature babies have a normal life?

Yes. The chances of a premature baby growing up to be healthy are quite good, especially if they were born after 34 weeks of pregnancy. The earlier a baby is born, the more likely they are to have health complications that could affect them later in life.

Is being born premature a disability?

No, being born early isn’t a disability. It only increases your risk for certain disabilities.

When should you contact your healthcare provider about preterm labor?

Contact your healthcare provider immediately if you notice any of the following signs of preterm labor:

• Irregular vaginal discharge (like leaking amniotic fluid) or bleeding.
• Contractions or cramping, with or without diarrhea.
• Ongoing pain in your lower back.
• Pressure in your pelvis or abdomen.
• Your “water breaks.”

If you have a health condition like diabetes, hypertension (high blood pressure) or preeclampsia, contact your healthcare provider if you’re having trouble managing your condition. Although preterm delivery may not be entirely preventable, your provider will work with you to manage the condition, which may extend the pregnancy to avoid early delivery.