Are you prepared for prematurity?

A premature birth is one that happens before your 37th week of pregnancy (a typical pregnancy is about 40 weeks). And the earlier the birth, the greater the risk your baby will have serious health problems, as organs will not have developed fully. 

“Gestational age, as well as individual circumstances and the reason for premature labour may impact the antenatal management and neonatal outcomes,” says Dr Elize Wethmar, a gynaecologist and obstetrician in Benoni, who specialises in treating gynaecological cancers. 
 
In the first weeks after birth, a prem baby may have trouble breathing, due to under-formed lungs; heart problems (such as an opening between their aorta and pulmonary artery); brain problems (bleeding in the brain); digestive issues (issues with cells lining the bowel); blood problems (anaemia, jaundice); metabolism problems (low blood sugar); and immune system problems, which raise risk of infection and illnesses. They are also more at risk of sudden infant death syndrome.
 
Long term, premature birth is associated with developmental delays and a greater risk of cerebral palsy and learning disabilities, as well as visual, hearing and dental problems, behavioural and mental health problems, and ongoing health issues such as asthma.  

Know your risk

In South Africa it’s estimated that 15% of births are premature – one in seven babies, according to research in Frontiers of Pediatrics. The exact reason is often not clear, and preterm labour can affect any pregnancy, but there are factors that put you at greater risk. It’s important to be aware of them:

• A previous preterm labour or premature birth.
• More than one miscarriage or abortion.
• Carrying twins or other multiples.
• Less than six months between pregnancies.
• Fertility treatments (assisted reproduction, including IVF).
• A shortened cervix or problems with your uterus.
• Infections of your lower genital tract.
• Injuries or trauma to your body.
• Health problems such as diabetes, high blood pressure or cancer.
• Being underweight or overweight before becoming pregnant.
• Becoming pregnant before age 17 or after age 35.
• Stressful life events, such as death of a loved one or domestic violence.
• Smoking, taking recreational drugs or drinking alcohol often or heavily when pregnant.

Take action

If you tick any of these boxes, it’s essential to raise this with your health provider and get guidance and support in managing some of the risks, such as ones linked to lifestyle. 
 
If you’ve had a premature baby before, you may be put on progesterone supplements to help lower the risk of preterm birth, says Dr Wethmar. “If you have a short cervix, another option is a that a stitch may be put in to keep it closed until it’s time to have your baby. Certain activities may have to be reduced until then, depending on individual circumstances.”

Know the signs

Even if you don’t think you tick any boxes, be aware of the signs of preterm labour:
 
• Early contractions – regular or frequent feelings of your abdomen tightening.
• Low, dull backache.
• Pressure in your pelvis or lower abdomen.
• Mild abdominal cramps.
• Vaginal spotting, light bleeding.
• A change in vaginal discharge – watery, mucous-like or blood-stained.
• A trickle or gush of clear (amniotic) fluid (this signals a tear in the membrane around your baby).
 
If you notice any of these, or are concerned about any other changes, contact your health provider immediately. Don’t be embarrassed that it may be a false alarm – your and your baby’s wellbeing are paramount. 

Rather be safe than sorry, because even if the preterm labour cannot be stopped, certain medications can delay the labour. Consult your healthcare provider for more information. 

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