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Preterm labor: Take prevention seriously

Preterm labor can affect any pregnancy. Know the most common risk factors — and what you can do to nurture a healthy, full-term pregnancy.

By Mayo Clinic staff

A full-term pregnancy lasts about 40 weeks. Preterm labor refers to contractions that begin to open the cervix before week 37.

Often, the specific cause of preterm labor isn't clear — but that's not the end of the story. Taking good care of yourself can go a long way toward preventing preterm labor and delivering a healthy baby.

Why is preterm labor a concern?

If preterm labor can't be stopped, your baby will be born too soon. And the earlier preterm birth happens, the greater the risks for the baby — including low birth weight, breathing difficulties, underdeveloped organs and potentially life-threatening infections. Children who are born prematurely also have a higher risk of learning disabilities, developmental disabilities and behavior problems.

Who's at risk of preterm labor?

Preterm labor can affect any pregnancy. The most common risk factors include:

  • Previous preterm labor or preterm birth
  • Pregnancy with twins, triplets or other multiples
  • Certain problems with the uterus, cervix or placenta
  • Smoking cigarettes, drinking alcohol or using illicit drugs
  • Some infections, particularly of the amniotic fluid and lower genital tract
  • Some chronic conditions, such as high blood pressure and diabetes
  • Being underweight or overweight before pregnancy, or gaining too little or too much weight during pregnancy
  • Stressful life events, such as the death of a loved one or domestic violence
  • Multiple miscarriages

Still, many women who have preterm labor have no known risk factors.

Can preterm labor be prevented?

There are no guarantees — but there's much you can do to nurture a healthy, full-term pregnancy:

  • Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby's health. Mention any signs or symptoms that concern you, even if they seem silly or unimportant.
  • Eat healthy foods. During pregnancy, you'll need more folic acid, calcium, iron, protein and other essential nutrients. A daily prenatal vitamin — ideally starting a few months before conception — can help fill any gaps.
  • Manage chronic conditions. Diseases such as diabetes and high blood pressure increase the risk of preterm labor. Work with your health care provider to keep any chronic conditions under control.
  • Follow your health care provider's guidelines for activity. If you develop signs or symptoms of preterm labor, your health care provider may suggest working fewer hours or spending less time on your feet. Sometimes it makes sense to scale back other physical activities, too.
  • Avoid risky substances. If you smoke, quit. Smoking may trigger preterm labor. Alcohol and recreational drugs are off-limits, too. Even prescription and over-the-counter medications deserve caution. Get your health care provider's OK before taking any medications or supplements.
  • Ask your health care provider about sex. It's not a concern for women who have healthy pregnancies, but sex may be off-limits if you have certain complications — such as vaginal bleeding or problems with your cervix or placenta.
  • Manage stress. Set reasonable limits — and stick to them. Set aside some quiet time every day. Ask for help when you need it.
  • Take care of your teeth. Brush and floss daily, and visit your dentist for regular cleanings and dental care. Some studies suggest that gum disease may be associated with preterm labor and premature birth.

If you have a history of preterm birth or significant risk factors for preterm birth, your health care provider may suggest weekly shots of the hormone progesterone to help prevent preterm labor.

What are the signs and symptoms of preterm labor?

For some women, the clues of preterm labor are unmistakable. For others, the signs and symptoms are more subtle. Be on the lookout for:

  • Contractions that occur more than eight times each hour (You'll feel a tightening sensation in your abdomen, often reminiscent of menstrual cramps.)
  • Low, dull backache
  • A sensation of pelvic pressure
  • Diarrhea
  • Vaginal spotting or bleeding
  • Watery vaginal discharge

If you're concerned about what you're feeling — especially if you have vaginal bleeding accompanied by abdominal cramps or pain — contact your health care provider. Don't worry about mistaking false labor for the real thing. Everyone will be pleased if it's a false alarm!

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References
  1. Preterm labor. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp087.cfm. Accessed Feb. 18, 2009.
  2. Preterm labor and birth. National Institute of Child Health and Human Development. http://www.nichd.nih.gov/health/topics/Preterm_Labor_and_Birth.cfm. Accessed Feb. 18, 2009.
  3. Damus K. Prevention of preterm birth: A renewed national priority. Current Opinion in Obstetrics and Gynecology. 2008;20:590.
  4. Lockwood CJ. Overview of preterm labor and delivery. http://www.uptodate.com/home/index.html. Accessed Feb. 18, 2009.
  5. Norwitz ER. Prevention of spontaneous preterm birth. http://www.uptodate.com/home/index.html. Accessed Feb. 18, 2009.
  6. Robinson JN, et al. Risk factors for preterm labor and delivery. http://www.uptodate.com/home/index.html. Accessed Feb. 18, 2009.
  7. Simhan H, et al. Inhibition of acute preterm labor. http://www.uptodate.com/home/index.html. Accessed Feb. 18, 2009.
  8. Caritis S, et al. Management of pregnant women after inhibition of preterm labor. http://www.uptodate.com/home/index.html. Accessed Feb. 18, 2009.
  9. Pain relief during labor and delivery. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp086.cfm. Accessed Feb. 18, 2009.
  10. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 20, 2009.

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May 23, 2009

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