The Causes of Preterm Labor

In the United States about 12% of all babies, about 1-in-8, are born prior to 37 weeks gestation. Preterm birth is the leading cause of death in a newborn. It is also the leading cause of death for infants in many states. Unfortunately the trend is expected to get worse.

We are still trying to understan why preterm labor happens, causing babies to be born before their time. However, currently we only know what has caused the preterm labor in about half of all of the labors being effected.

When preterm labor starts on its own (as opposed to being induced):

• Infection. About 40-50% of all preterm labor can be traced to infection. Many women do not show classic signs of infection, like fevers. One good note here is that with antibiotic treatement for Group B Strep, we have seen a reduction. Other than for Group B Strep, antibiotics usually lead only to antibiotic resistance and not a reduction in preterm labor rates.

• Bleeding. This does include placental abruption, where the placenta tears away from the uterine wall too early. It also includes bleeding disorders that may be genetic or acquired. Bleeding of any sort should be reported to your doctor or midwife.

• Stretching of the uterus. The stretching or overdistension of the uterus has also been linked to preterm labor and birth. This can be caused by fibroids, multiple pregnancies (twins, triplets, etc.), or even having too much amniotic fluid (polyhydramnios).

About 25% of all preterm births to mothers with one baby are ended early for maternal or fetal well-being. This can be acheived either through induction of labor or by planned cesarean section, depending on the reason for the early arrival and the condition of mom and baby. The American College of Ob/GYNs (ACOG) says that there should not be any induction done prior to 39 weeks without medical reason (often called social induction), because of the increased risks. That leaves 75% of preterm labors as spontaneous. About a quarter of the spontaneous preterm labors are due to premature rupture of membrames (PPROM).

Research is ongoing as to the causes of preterm labor and how to prevent this dangerous complication. The biggest thing to be aware of are the signs of preterm labor and what risk you are at with your current pregnancy.