Introduction
A premature birth refers to the birth of a baby that is below the normal gestation period of 37 weeks. Premature birth is responsible for a great number of neonatal mortality. Consequently, infants are exposed to lifelong complications such as disabilities, abnormal growth as well as impaired mental development. Though the causes of premature births continue to be unknown, a myriad of factors is associated with the possibility and chances of mothers experiencing preterm births. Normally several human organs mature at the onset of the 37th week in full-term babies. If the baby is born before this, prematurely is deemed to have occurred. In recent years cases of premature births have gone up in more developed countries, today the rate stands at 12-13% in the United States. Certain events may precede premature births; this may include spontaneous premature birth which is preceded by premature labor, premature births caused by the premature rupture of birth membranes, and premature births that are induced by obstetricians for obstetrical reasons mostly due to intrauterine infections that may pose a significant threat to a mother’s health. According to statistics, the most severe prematurity occurs between 28-31 weeks while the least severe occurs at 34-36 weeks. Studies have also been able to link a low birth weight of less than 2500gm to premature delivery consequently, premature deliveries continue to be a cost factor in the healthcare system since a correlation exists between prematurity and subsequent disability in infants.
Signs of premature birth
Signs of impending premature births vary but the most common symptoms include premature labor which is preceded by several contractions of the uterine walls in a short period before the full gestation period lapses. This is may also be characterized by vaginal bleeding in the final trimester with significant pressure in the pelvis as well as abdominal and back pains. Discharge from the vagina may also be indicative of premature rapture of birth membranes. In other cases, the dilation of the cervix may prompt a premature delivery. These abnormal contractions usually occur without pain or prior warnings to the mothers.
Causes
Numerous studies have been unable to adequately pinpoint the causes of premature births but several factors have been identified that have a considerable association with preterm births. This include, precocious fetal endocrine activation which in most cases results from the mechanical stretch of the uterus and by an endocrine pathway as a result of increased activity in the uterine axis. Cortisol which is generated from cortisone is responsible for the stimulation of uterine activity this coupled with other agents such as cytokines may enhance the production of prostaglandin or the corticotrophin-releasing hormones thus stimulating the placenta. This may eventually give rise to preterm birth. Residual bleeding which occurs in the first trimester is caused by an imbalance of hormones; though not harmful to the growing baby a consistent occurrence coupled with other factors might lead to a pre-birth. Uterine over-distension and intrauterine infections may also contribute to pre-birth cases. Apart from the biological causes, several environmental factors may increase the risk of pre-mature births. Socio-economic factors that have a direct inclination to educational standing, the age of the mother be it above the reproductive age of 35 or less than 18 years and pregnancy intervals may increase the risk of pre-mature births. Studies have also indicated that extreme or extraneous physical activity has some bearing on preterm births. Patients who have had previous abortions coupled with a poor nutrition regimen have also been shown to have a higher risk of experiencing pre-term births. Adequate nutrition with a provision of all dietary elements is essential for normal pregnancy. A diet that is low on cholesterol and saturated fats is highly recommended to significantly reduce the risk of preterm births. Studies have also indicated that multiple pregnancies ie of twins and triplets significantly increase the risk of pre-mature births as opposed to singleton births. The use of fertility drugs that stimulate the release of multiple eggs for fertilization as well as the use of in vitro fertilization has been known to enhance preterm births. In essence, it can be concluded that a myriad of factors that include high blood pressure, diabetes, a weak cervix, heart diseases, depression, as well as the abuse of hard drugs like cocaine and tobacco during pregnancy can put women at higher risk of experiencing preterm pregnancies.
Detection
The risks of premature births must be predicted early enough. However, the accurate prediction of pre-term labor has been hampered by a lack of distinction between true and false labor. Several tests like fetal fibronectin have been important in the detection of possible pre births. The presence of fibronectin protein in vaginal secretions is indicative of a disruption in the chorion. An ultrasound test has also been useful in the detection of pre births. A short cervix in the 24th week of the pregnancy is deemed to increase the risk of premature births.
Mitigation measures
Several measures have continued to be encouraged as a way of mitigating or avoiding the occurrence of pre births. Among them include avoiding repeated abortions as well as the use of fertility treatments that enhance the chances of conceiving. Exposure to stress and strenuous physical work is discouraged in pregnant women. Nutritional measures that encourage the intake of vitamins, as well as other vital supplementation, is important. Pregnant women are also instructed to quit smoking and drugs to reduce the occurrence of pre-mature births. Pregnant women are also encouraged to seek proper medical advice as well as avoiding infections to minimize the risk factors.
Work Cited
Goldenberg, Culhane, Iams and Romero. Epidemiology and causes of preterm birth. Chicago: University of Chicago Press, 2008.
Krupa, G., Faltin D., Cecatti JG., Surita FG. And Souza JP. Predictors of preterm birth. New York: Oxford University Press, 2006.
Lamont and Jaggat, Emerging drug therapies for preventing spontaneous preterm labor and preterm birth. New York: Guilford Press, 2007.