Premature birth is not really a rare thing, but even so, the increase in cases of premature birth is a legitimate concern. According to the World Health Organisation (WHO), preterm birth complications are the primary cause of death among children below five years, and account for nearly a million deaths in 2015.

Despite this disparaging statistics, the good news is that steps can actually be taken to prevent this trend from continuing. As echoed by the WHO, three-quarter of deaths due to premature birth could in fact be saved with current, cost-effective interventions.

1. Maintaining healthy maternal weight

Keeping maternal weight in the healthy zone is a big deal for a pregnant woman, for the benefit of both the mother and the baby. A study published in the recent issue of Journal of the American Medical Association (JAMA) found that expectant mothers who weigh too little or too much during pregnancy may encounter risks of severe illnesses, which can also be life-threatening.

"Not only for the baby's sake, but also for your own sake. Have a healthy diet and get regular exercise before pregnancy," says the study lead author, Dr Sarka Lisonkova.

Two other studies have also linked a pregnant mother’s weight with the risk of premature birth. In one study, babies born to underweight women had higher risks of preterm birth and low-birth weight. In another study, women being at the other extreme of the scale, as in overweight and obese, face the same risk, too. This risk is similar between women in developing and developed countries.

2. Getting proper nutrition

The old adage of “eating for two” is often used as the justification for pregnant mothers to eat more. This would perhaps be correct: if perceived from the quality – and not quantity – point of view. Although proper nutrition promotes the baby’s growth and development, a prudent dietary pattern, which includes foods like vegetables, fish, whole grains, fruit and water during pregnancy, could reduce the risk of preterm delivery.

One study found a specific association between dairy products enriched with probiotic and the reduced risk of spontaneous premature birth. Proper nutrition intake also means staying away from artificially-sweetened and sugar-sweetened beverages, as they are found to increase the risk of preterm delivery.

3. Avoiding stress

Alleviating the exposure to stress can help reduce the risk of preterm birth.
Alleviating the exposure to stress can help reduce the risk of preterm birth.

It is perhaps easier said than done; but, avoiding stress is particularly important for pregnant mothers. Stress is attributable to many factors, ranging from financial problems to relationship issues. A study showed that even a stressor that is not causing a clinical diagnosis can have an impact on the risk of premature delivery.

Moreover, researchers also found that “maternal stress during pregnancy is more than twice as common among women who gave birth preterm compared to women who gave birth at term”. This indicates a clear importance of identifying early signs of stress in expectant mothers as well as alleviating the exposure to stress to reduce the risk of preterm birth.

4. The “ideal” age

How does one determine the “ideal” age to have a baby to avoid premature birth? A study found that women aged 35 years and older in their first pregnancy are considered a risk group for preterm birth, and that earlier inducing their labour could reduce the number of prenatal deaths.

“The number of first-time mothers over the age of 35 is rising. Although their risk of experiencing a stillbirth or neonatal death is relatively small, it’s still very important that these women receive the best advice on how to minimise the risks to themselves and their baby,” says Hannah Knight, lead author of the London School of Hygiene and Tropical Medicine.

On the other hand, preterm birth has also been linked to young maternal age. Teenage mothers have an increased risk of premature delivery, especially those aged 14 to 17 years with greater risk, as well as those in their second pregnancy. Biological immaturity and lack of appropriate prenatal care have been suggested as possible factors, as previous research showed that teenage pregnant women are less likely to seek prenatal care.

5. Optimal care

Quality prenatal care can have a potential impact on reducing preterm birth.
Quality prenatal care can have a potential impact on reducing preterm birth.

Getting a glimpse of the growing baby on the ultrasound monitor is often one of the most exciting moments during pregnancy. Nevertheless, pregnant mothers need to understand that there is more to optimal prenatal care than just getting an ultrasound. Women who are at risk of giving birth prematurely can be identified during prenatal care, based on certain pre-existing conditions that may be present. Besides the frequency of visits, initiation and content of care as well as the services provided during a prenatal appointment, can have a potential impact on reducing preterm birth.

Research has shown that women who started care before the 14th week of conception and received a minimal number of blood pressure measurements, ultrasounds and blood samples in the relevant pregnancy trimesters had the lowest risk for a premature delivery, compared to those receiving less appropriate care.

As the global community observes World Prematurity Day, a better understanding of ways to minimise the risks of preterm birth would hopefully empower women – and ensure them a positive pregnancy experience. MIMS

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