Preterm Labor: how Will This Affect Future Deliveries?

Preterm birth happens when a woman gives birth before 37 weeks of pregnancy. With this issue complicating about 12 percent of all pregnancies in the United States, many parents wonder how it could affect their future pregnancies. For the woman who has delivered preterm before, there are definitely some things that will be different the second time around.

Having a history of preterm birth is a risk factor for delivering preterm again. In fact, this almost doubles the risk of having a preterm baby in future pregnancies. Because of this, women with this history are considered high risk and are watched a little more closely in all future pregnancies.

Unfortunately, no one thing can be labeled as the reason labor starts, preterm or not. And because of this, that means there is no one simple test to detect preterm labor or to know that a woman will give birth early. However, some or all of the things listed here may be used to help a woman give birth to a happy, healthy, full-term baby:

1. Have a detailed history taken to review risk factors.

At the first prenatal visit, a thorough history should be taken. If there are risk factors for preterm birth present that can be changed (such as smoking, for example), they should be identified.

2. Extra ultrasounds to measure the length of the cervix.

Most obstetricians will recommend using transvaginal ultrasound to measure the cervical length starting at around 16 weeks of pregnancy. A cervix that is shorter than normal can be a sign of preterm labor or be a reason that additional testing and treatments are needed.

3. Receive progesterone shots (17-hydroxyprogesterone caproate).

We know based on studies that women who have delivered preterm and then receive weekly progesterone injections (17-hydroxyprogesterone caproate) in future pregnancies cut their risk of delivering preterm by 31–39 percent! Because of this, these injections are routinely prescribed for women who’ve delivered early.

4. Have a stitch placed in the cervix to help keep it closed.

Called a cerclage, this is a stitch placed around the cervix to keep it from dilating. While there is some variation in how they are used, many obstetricians will recommend them for pregnant women who have a history of preterm delivery and also currently have a very short cervix.

5. Be made aware of signs of preterm labor.

It sounds simple, but educating women on the signs of preterm labor can help them identify it sooner. You can read more about what to look for here.

6. What about bed rest, home contraction monitoring, or medications to stop contractions?

Unfortunately, we know that putting pregnant women on bed rest does nothing to help with preterm labor and may actually make other problems worse. The same goes for using home contraction monitors or taking medication to stop preterm contractions before they’ve even started: there is no evidence they help, and using these interventions can actually lead to more problems.

Sources:

• The American College of Obstetricians and Gynecologists
• Practice Bulletin #130: Prediction and prevention of preterm birth
• October 2012.
  SG GAbbe et al
• Obstetrics: Normal and problem pregnancies
• 5th ed.

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