Prematurity: The Leading Cause of Infant Death

What is prematurity?

A full-term pregnancy lasts about 40 weeks.  Babies born before 37 weeks are considered “premature”. Babies born early can have serious short- and long-term health problems because their organs, such as the lungs, heart, and brain, are not fully developed. The health complications caused by prematurity are the leading cause of infant deaths in Milwaukee and the United States.

What contributes to prematurity?

• Smoking and exposure to second-hand smoke during pregnancy
• Use of illegal drugs and medications not prescribed by a doctor during pregnancy
• Infections such as urinary tract infections (bladder infections), vaginal infections, and sexually transmitted infections (STI). Some of these infections may not have obvious symptoms.
• Getting pregnant within a year after the last baby was born
• Starting medical care with doctor/practitioner/midwife after 14 weeks of pregnancy, or not going in for regular prenatal medical appointments.
• Gaining too much or too little weight during pregnancy
• Drinking alcohol, including beer and wine, during pregnancy
• Experiencing high levels of stress over long periods of time

Are there any other risk factors?

• If you have experienced a premature birth in the past- you have a very high chance of another one. Talk to your doctor about ways to prevent a repeat.
• If you are younger than 18 or older than 35, you are at especially high risk for a premature birth. Again, talk to your doctor.

What steps can I take before I get pregnant?

While not all premature births be prevented, there are several steps you can take to prevent your baby from being born too early. The following steps are all known to decrease the possibility of having a premature baby.

• If you smoke, quit before you become pregnant.  A number of smoking cessation programs are available to help.
• Avoid other smokers.  Secondhand smoke can be just as bad for you as smoking yourself.
• Be sure to get regular medical care, including annual pap smears and tests to check for infections.  
• Be sure to get regular dental care and seek treatment immediately for any mouth pain or swelling.
• Take only medications that have been prescribed or suggested by your doctor
• Cut back on drinking alcoholic beverages, including beer and wine
• Eat a well-balanced diet and exercise regularly.
• Minimize your stress by taking time to relax and have fun
• Plan your pregnancies. A minimum of a year between pregnancies is best but two years between is even better.
• If you want to wait to get pregnant, practice safer sex, using condoms along with another method of birth control.

I’m pregnant! How can I decrease my chances of having a premature baby?

• Quit smoking immediately. Also, avoid being around other smokers.  Even second-hand smoke is hazardous for you and your baby.
• Do not drink any alcoholic beverages, including beer and wine
• Get to a doctor as soon as possible, and see them regularly throughout your pregnancy
• Have regular tests for infections such as urinary tract infections (bladder infections), vaginal infections, or sexually transmitted diseases
• See a dentist at least once during your pregnancy, and call your dentist for any mouth pain or swelling
• Eat a variety of nutritious foods, including fruits and vegetables, and drink 6 to 8 glasses of water every day.
• Gain weight steadily throughout your pregnancy. Talk to your doctor or midwife about the amount of weight you should expect to gain. 
• Use condoms during sexual intercourse to prevent infection
• Pay attention to your baby’s movements and report any changes to your doctor or midwife immediately, especially if your baby’s movement decreases or stops
• Know the signs of preterm labor, such cramping, vaginal bleeding, pains that come and go, pressure in pelvic area.  Call your doctor or midwife immediately if you experience these or any other unusual symptoms.
• Plan time for fun and relaxation. 
• If your partner or any household member injures you, threatens to hurt you or makes you feel afraid, you should talk to someone you trust or to a professional like a doctor, nurse or social worker.  You can also call the Domestic Violence Hotline 24 hours a day @ 933-2722.
• Call the Milwaukee Health Department at 414-286-8620 to have a nurse come to your home while you are pregnant.

More information

• 2011 Infant Mortality Summit:  Focus on Prematurity: http://city.milwaukee.gov/Health/News-and-Events/Infant-Mortality-Summits
• MHD’s opinion piece on prematurity for the Milwaukee Journal Sentinel http://www.jsonline.com/news/opinion/95652009.html
• Wikipedia information on prematurity: http://en.wikipedia.org/wiki/Preterm_birth
• March of Dimes http://www.marchofdimes.com/mission/prematurity-campaign.aspx