Risk of Preterm Birth: 4 Factors You Should Watch Out For

Every pregnancy carries hope, expectation, and careful planning for the baby’s arrival around the expected due date. But sometimes, a baby arrives too soon, before the pregnancy reaches full term. This situation, known as a preterm birth, can raise serious health concerns for both the mother and the child.

Many people wonder what causes this to happen or how they can lower the risk of preterm birth.

In this article, we’ll explore the key factors that increase this risk and what can be done to reduce it. This will provide you with a clear understanding of the biological, lifestyle, and environmental triggers that influence preterm labour and how timing plays a critical role in newborn health.

Let’s Understand Preterm Birth

What is Preterm Birth?

Preterm birth occurs when a baby is born before 37 completed weeks of pregnancy, counting from the mother’s last menstrual period. A normal pregnancy lasts about 40 weeks, and this extra time allows the baby’s organs, especially the lungs, brain, and liver, to develop completely.

Babies born prematurely may be classified based on how early they arrive:

Late preterm: 34 to 36 weeks
Moderately preterm: 32 to 34 weeks
Very preterm: Less than 32 weeks
Extremely preterm: Before 28 weeks

Each week of pregnancy makes a major difference. Babies born earlier often face greater health challenges, including breathing difficulties, feeding problems, and a higher risk of long-term complications.

That’s why understanding the risk of preterm birth and addressing contributing factors early in pregnancy is so important.

Why Birth Time Matters?

The timing of birth has a powerful influence on a baby’s survival and future health. A baby’s organs mature rapidly during the last few weeks of pregnancy.

For example, the lungs continue to develop until about 36 weeks, and the brain grows nearly one-third of its final weight between weeks 35 and 40. When birth happens too early, these organs may not be ready to function outside the womb.

For mothers, preterm labour can also lead to emotional stress and additional medical challenges. By identifying and managing the risk of preterm birth early, healthcare providers can offer interventions that improve outcomes for both mother and preterm baby.

What is the Global Scenario of Preterm Birth?

Worldwide, an estimated 13.4 million babies are born preterm each year, roughly 1 in 10 births. Preterm birth is one of the leading causes of death in children under five, contributing to nearly a million deaths annually. Even when babies survive, many face lifelong health and developmental issues that can affect education, growth, and quality of life.

Low and middle-income countries carry the highest burden, but preterm births also occur in wealthier nations due to factors like delayed childbearing, fertility treatments, and medical complications. These statistics underline the urgent need for global awareness and better maternal care to lower the risk of preterm birth.

For example, in the United States, about 10% of all births are preterm each year. In India, the rate is among the highest globally, contributing significantly to newborn mortality. Countries that have invested in prenatal screening, maternal education, and infection control have seen gradual improvements in outcomes.

What Factors Lead to the Risk of Preterm Birth?

The risk of preterm birth doesn’t depend on a single factor. It results from a complex mix of maternal, fetal, social, and environmental conditions. Understanding these risk groups helps identify where timely intervention can make the biggest difference.

I. Maternal Factors

Certain biological and personal characteristics make some women more likely to face preterm labour. A mother’s overall health strongly influences pregnancy outcomes.

Age Below 17 or Above 35

Pregnancies among teenagers or older mothers are statistically linked to higher preterm birth risks. Teenagers may face poor nutrition or incomplete physical development, while older women are more likely to have chronic conditions such as hypertension or diabetes. Both age groups should receive close prenatal monitoring to reduce the risk of preterm birth.

Short Birth Spacing

When pregnancies occur less than 18 months apart, the mother’s body may not have enough time to recover physically and nutritionally. This short gap can increase the chances of uterine strain, anaemia, and early labour. Experts recommend proper birth spacing to allow the body to rebuild strength before the next pregnancy.

Multiple Babies

Carrying twins, triplets, or more greatly raises the risk of preterm birth. The uterus becomes overstretched earlier, and the demand for nutrients increases. Most multiple pregnancies end before 37 weeks, making regular checkups and nutritional monitoring essential to ensure safe outcomes.

Past Preterm Birth

A woman who has experienced a preterm birth in a previous pregnancy is more likely to have it again. This may be due to underlying cervical, hormonal, or structural issues. Specialised prenatal care and preventive treatments, such as progesterone therapy, can help reduce recurrence.

Chronic Diseases

Chronic illnesses like heart disease, kidney disorders, autoimmune conditions, and asthma can complicate pregnancy and increase the risk of preterm birth. Proper disease management, medication adjustment, and early consultation with specialists play a key role in keeping pregnancies stable and full-term.

II. Lifestyle Factors

Daily habits and emotional well-being have a deep influence on pregnancy health. Some lifestyle factors directly raise the risk of early labour.

Smoking and Vaping

Nicotine and carbon monoxide restrict oxygen flow to the baby, slowing growth and triggering early contractions. Even secondhand smoke can harm both mother and child. Quitting smoking before or during pregnancy significantly lowers the risk of preterm birth.

Alcohol and Drugs

Alcohol and certain recreational drugs interfere with fetal development and increase the chances of premature delivery. These substances can damage the placenta and alter hormone balance, leading to premature labour or low birth weight. Avoiding alcohol and drug use entirely during pregnancy is the safest choice.

Poor Nutrition

A balanced diet is vital during pregnancy. Lack of essential nutrients like iron, calcium, and folic acid can weaken the mother’s health and affect fetal growth. Underweight mothers and those with eating disorders are at higher risk. Good nutrition helps strengthen immunity and lowers the risk of preterm birth.

High Stress

Chronic emotional or physical stress increases levels of stress hormones like cortisol, which can influence early contractions. Anxiety, domestic violence, or financial pressures can also raise the chances of preterm birth. Counselling, relaxation techniques, and social support can help reduce the negative impact on pregnancy.

III. Pregnancy Factors

Certain medical complications directly related to pregnancy can lead to early birth if not managed properly.

Infections

Infections of the amniotic fluid, urinary tract, or reproductive system can cause inflammation that triggers early labour. Even mild, untreated infections may lead to serious complications. Routine screening and timely antibiotic treatment are important preventive steps.

High Blood Pressure

Conditions like preeclampsia or gestational hypertension limit blood flow to the baby and can require early delivery to protect both mother and child. Regular blood pressure monitoring during prenatal visits helps detect warning signs early.

Gestational Diabetes

When blood sugar levels rise during pregnancy, it can cause excessive fetal growth or placental problems, increasing the risk of preterm birth. Managing blood sugar through diet, exercise, and medical care helps maintain a healthy pregnancy duration.

Fetal Conditions

Some preterm births are linked to issues directly affecting the baby. Growth restriction, where the baby isn’t growing as expected, can trigger early delivery to protect the child’s health. Identifying fetal conditions early through ultrasound and genetic screening helps guide safer decisions and manage the risk of preterm birth more effectively.

Placental Problems

Issues such as placenta previa (placenta covering the cervix) or placental abruption (placenta detaching too early) often lead to bleeding and may require early delivery. Regular ultrasounds can detect these conditions before they become dangerous.

Uterine or Cervix Changes

A weakened cervix (cervical insufficiency) or an abnormally shaped uterus can make it difficult to carry the pregnancy to term. Procedures like a cervical stitch (cerclage) or progesterone support are often used to help prevent preterm labour in these cases.

IV. Environmental Factors

The environment a woman lives and works in can also affect her pregnancy health in subtle but powerful ways. The current environmental condition has hazardous effects on the health of every human. It intensifies more with conditions like pregnancy when taking in toxic chemicals and polluted air.

Women with limited financial or social support may experience higher emotional stress, poor nutrition, or delayed medical attention, all of which contribute to early labour.

Exposure to Pollution

Exposure to fine particulate matter from vehicle emissions, wildfire smoke, or industrial sources has been linked to higher rates of premature delivery.

Environmental pollution can cause inflammation and restrict oxygen supply to the placenta, raising the risk of preterm birth. Pregnant women are encouraged to limit outdoor activity on poor air-quality days.

Workplace Hazards

Women who work in settings involving long hours, standing, heavy lifting, or chemical exposure may face increased risks. Employers and healthcare providers can help by offering safe work adjustments and maternity leave when necessary.

Limited Prenatal Care

Regular prenatal care allows doctors to detect complications, provide vaccinations, and monitor growth. Missing appointments or lacking access to quality healthcare increases the chance of unnoticed problems that can trigger early labour.

Improving access to prenatal services is one of the most effective ways to reduce the global risk of preterm birth.

What Are the Warning Signs of Premature Delivery?

Recognising the early warning signs of preterm labour can make a vital difference. Timely medical help often prevents early delivery or reduces related complications. Expectant mothers should stay alert for any unusual symptoms during the second or third trimester.

Early Contractions

Regular or frequent contractions before 37 weeks can indicate early labour. These may feel like a tightening in the lower abdomen or back pain that comes and goes. If contractions occur every 10 minutes or less, it’s important to contact a healthcare provider immediately. Monitoring these signs early can help manage the risk of preterm birth.

Fluid Leakage

Any sudden gush or slow trickle of fluid from the vagina could mean the amniotic sac has ruptured. This condition, known as premature rupture of membranes (PROM), requires urgent medical attention. Once the protective fluid is lost, both the baby and mother are at risk of infection or early labour.

Pelvic Pressure

A heavy feeling in the lower pelvis, backache, or menstrual-like cramps may signal that the cervix is beginning to open prematurely. Other symptoms can include vaginal spotting or changes in discharge. These early warnings should never be ignored, as they may point to a growing risk of preterm birth.

What are the Prevention Steps to Avoid Preterm Birth?

While not all preterm births can be prevented, proactive medical care and healthy habits significantly reduce the risks. Prevention focuses on strengthening the mother’s health, supporting the cervix, and managing complications before they escalate.

Progesterone Shots

Progesterone, a hormone that supports pregnancy, helps the uterus stay relaxed and prevents contractions. Progesterone shots or vaginal suppositories are often prescribed to women with a history of preterm birth or a short cervix. This therapy can substantially lower the risk of preterm birth.

Cervical Stitch

A cervical cerclage, or stitch, is a small procedure where the cervix is sewn closed to prevent early opening. It’s usually done between 12 and 14 weeks for women with cervical insufficiency. The stitch is removed close to the due date once the baby is ready to be born.

Treating Infections

Promptly diagnosing and treating urinary, vaginal, or systemic infections can reduce inflammation that may trigger preterm labour. Good hygiene and routine testing during prenatal visits are simple but effective preventive steps.

Low-Dose Aspirin

In women at risk of preeclampsia or poor placental function, doctors may recommend a low-dose aspirin regimen. This improves blood flow between the placenta and the baby, reducing complications that contribute to the risk of preterm birth.

Lifestyle Support

Maintaining a healthy weight, eating nutritious foods, managing stress, avoiding smoking and alcohol, and getting enough rest all strengthen the mother’s body. Emotional support from family and healthcare providers is equally crucial in promoting a full-term pregnancy.

What are the Long-Term Effects of a Premature Delivery?

Health Effects

Some preterm babies may face ongoing challenges such as breathing issues, vision problems, or learning difficulties.

However, with modern medical care and early intervention, most preterm babies grow up healthy and active. Regular follow-ups with paediatricians ensure timely support for any complications of a preterm baby.

Child Development

Early-born babies might reach milestones like sitting, walking, or talking slightly later than full-term babies.

Tracking growth based on corrected age (age adjusted for early birth) gives a more accurate measure of progress. Developmental therapies can help children catch up over time.

Family Support

Parents of premature babies often experience anxiety and fatigue. Support groups, counselling, and parental education programs can help families cope emotionally and build confidence in caring for their child. Family involvement is key to long-term well-being.