The material was prepared by the specialist of the Perinatal Center, a neonatologist.
The indicator of preterm birth in our country for almost thirty years has been kept at about the same level – seven to eight percent. The proportion of children with extremely low weight is five percent, and the proportion of children weighing up to a kilogram is ten percent. The cause of preterm birth is in many cases unknown or subtle. So, the causes of 50% of preterm births have not been determined. As a result, it is very difficult to reduce the number of preterm births. Significant progress has been made in nursing preterm infants, but not in reducing the number of preterm births.
Four reasons out of all the many other causes of preterm birth are proven:
- the premature activation of the endocrine system of the fetus;
- overstretching of the uterus;
- placental bleeding;
- inflammatory processes in the uterus as a result of infection
Activation of one or more pathological processes can occur gradually over the course of weeks or even months.
Infections play a major role in the origin of preterm labor, and about 25–40% of these can be attributed to them. Endorphins produced by microorganisms and anti-inflammatory cytokines produced by a woman’s body stimulate the response of the endometrium (the inner layer of the tissues lining the uterus), including the release of prostaglandins (hormone-like substances), which in turn stimulate uterine contractions. The further response of the endometrium may include the release of enzymes that destroy the fruit membranes, which leads to their thinning and the outflow of amniotic fluid. Typical microorganisms found in the organs of the female reproductive system before the rupture of the amniotic membranes are different types of mycoplasmas and ureaplasmaureticum.
A number of maternal bacterial infections can be associated with preterm delivery, including pyelonephritis, asymptomatic bacteriuria (excretion of microorganisms in the urine without signs of disease), pneumonia, and appendicitis. In addition, many studies have shown that periodontal diseases (inflammation of the tissues surrounding the teeth) are associated with premature birth.
It is suggested that bacterial vaginosis (vaginal dysbiosis) before and during pregnancy can affect the inflammatory response of the endometrium, which leads to premature birth.
In contrast, viral infections (ARIs), although they cause fever, are not considered the main factors leading to preterm delivery.
Premature birth can happen to any pregnant woman. However, some women have a higher risk. Scientific research on preterm birth is ongoing. Of course, some risk factors have already been identified, but it is still not always possible to predict which woman will give birth prematurely. If a woman is at risk, this does not mean that her birth will be necessarily premature.
The greatest risk of preterm birth is in those women who:
- Have a history of preterm birth
- Have a multiple pregnancies
- Have a special structure of the uterus or anomalies of the cervix
Some studies have shown that a certain lifestyle can lead to a risk of preterm birth:
- Lack of monitoring during pregnancy
- Alcohol abuse
- Drug use
- Physical, sexual or emotional abuse
- Lack of social support
- Long work shift and long-standing
- Living in an environmentally disadvantaged area
Certain diseases and medical conditions can increase the likelihood of premature birth:
- Genitourinary tract infections, sexually transmitted diseases
- High blood pressure, preeclampsia
- Blood coagulation disorders (thrombophilia)
- Genital bleeding
- Congenital malformations of the fetus
- In vitro fertilization
- Weight loss before pregnancy
- The short period between pregnancies (less than 6–9 months between the birth of the previous child and the new pregnancy)
In addition, medical studies have identified the following risk groups for preterm birth:
- African American
- Women under 17 and over 35
- Low Income
WHAT SHOULD WHARN A WOMAN DURING PREGNANCY? WHAT DO YOU NEED TO PAY ATTENTION TO?
Contact your healthcare provider immediately if you
have at least one of the following symptoms:
- spotting from the genital tract;
- copious fluid discharge from the vagina;
- persistent headache, visual impairment with the appearance of spots or flashes in the eyes;
- sudden swelling of the hands or face;
- temperature increase up to 38º С and more;
- severe itching and burning in the vagina or increased vaginal discharge;
- burning and pain during urination;
- severe abdominal pain that does not subside, even when you lie and relax;
- more than 4-5 contractions per hour;
- if you hurt your stomach during a fall, car accident, or if someone hit you;
- after six months of pregnancy – if your baby takes less than 10 movements within 12 hours.