Up to one-quarter of preterm births might be prevented if women
paid attention to three risk factors that are under their control, new
research suggests.
Those factors include spacing pregnancies well, beginning at a
healthy weight and gaining the recommended amount during the pregnancy,
the researchers found.
“These are all risk factors for a really serious health outcome —
preterm birth,” said study co-author Dr. Emily DeFranco. She is a
researcher at the Center for Prevention of Preterm Birth at Cincinnati
Children’s Hospital.
Babies born before 37 weeks’ gestation are considered preterm.
Being born early puts babies at risk for breathing, heart,
gastrointestinal and developmental problems, among other issues.
In the United States, the overall rate of preterm birth is 11.4
percent — more than twice as high as that in several other developed
countries, the researchers said.
Experts have identified many risk factors for preterm birth, so
DeFranco’s team looked at some that are manageable to see what role they
might play.
The investigators used records of nearly 400,000 births between
2006 and 2011 to examine the three risk factors. None were multiple
births.
More than 90 percent of the women had at least one of the three risk factors, the study findings showed.
Only 6 percent had none, providing what researchers called an
“ideal” comparison group. Their pregnancies were well spaced, their
weight was healthy at the start and the mothers gained no more, or less,
than recommended during pregnancy.
These “ideal” women had a preterm birth rate of 7.6 percent,
according to DeFranco, who is also an associate professor of
maternal-fetal medicine at the University of Cincinnati College of
Medicine.
Women who had less than a year between pregnancies as well as those
who gained too little weight during pregnancy had higher rates of
preterm births, the study authors said.
The highest rate of preterm births — at 25 percent, more than
triple that of the ideal group — occurred among women who were
underweight when they got pregnant, had shorter gaps between pregnancies
and inadequate weight gain during pregnancy, the researchers reported.
Women who are underweight are advised to gain 28 to 40 pounds
during pregnancy, while normal weight women should aim for 25 to 35
pounds, according to Institute of Medicine recommendations. Overweight
women should gain 15 to 25 pounds, and those who are obese should only
gain 11 to 20 pounds.
A body mass index (BMI) between 18.5 and 24.9 is considered a
healthy weight. BMI is an estimate of body fat based on height and
weight.
“You have some control over your risk of a preterm birth,” DeFranco
said, urging women to pay attention to the factors they can adjust.
Other risks are not changeable. For instance, black women are more
likely to have preterm births, as are women who have had a previous one
and those who conceive through in vitro fertilization, the researchers
said.
Dr. David Mendez, a neonatologist at Nicklaus Children’s Hospital
in Miami, reviewed the study. He pointed out that the findings build on
some things that doctors have suspected.
“It does appear to show that the uterus needs some recovery time,
and the mom needs to be at a healthy weight to have the best outcome,”
he said. Paying attention to the recommended weight gain is also
important, he added.
For women who are trying to conceive, Mendez said, the message seems to be to try to get to a healthy weight ahead of time.
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