Preterm birth refers to the delivery of a baby before 37 completed weeks of pregnancy. This condition poses significant risks to both maternal and newborn health and remains one of the leading causes of neonatal deaths and long-term health complications worldwide, as well as in our country.
While not all causes of preterm birth are fully understood, many risk factors have been identified. These factors, either individually or in combination, can influence the course of pregnancy and lead to preterm delivery.
Medical Causes and Known Risk Factors
Medical conditions that increase the likelihood of preterm birth include:
- History of preterm birth: Women who have experienced preterm birth in previous pregnancies have a significantly higher risk of recurrence.
- Multiple pregnancy (twins, triplets, etc.): The uterus stretches more quickly, and placental complications are more common, increasing the risk.
- Uterine and cervical abnormalities: Structural anomalies of the uterus or cervical insufficiency can make it difficult to sustain the pregnancy.
- Infections: Urinary tract, vaginal, or systemic infections can trigger preterm labor.
- Placental abnormalities: Conditions such as placental abruption (premature separation of the placenta) or placenta previa carry serious risks.
- Pregnancy-induced hypertension and preeclampsia: Uncontrolled high blood pressure in the mother raises the risk of early delivery.
- Gestational diabetes: Particularly when poorly controlled, it can lead to preterm labor.
- Polyhydramnios (excess amniotic fluid) and oligohydramnios (low amniotic fluid): Both can affect uterine tension and fetal development.
Maternal Lifestyle and Other Risk Factors
The mother’s general health, lifestyle habits, and pre-pregnancy characteristics also play a critical role. The following factors can increase the risk of preterm birth:
- Smoking, alcohol, or drug use
- Poor nutrition, inadequate weight gain, or severe obesity
- Stressful life events and low socioeconomic conditions
- Pregnancy at age 35 and older, or younger than 18
- Short interpregnancy intervals (conceiving within six months of the previous birth)
Biological Mechanisms of Preterm Birth
Several interconnected biological processes contribute to the onset of preterm labor, including:
- Early onset of uterine contractions
- Shortening or dilation of the cervix
- Rupture of the amniotic membranes
- Infection-related prostaglandin increase
Among these, a short cervical length is one of the most reliable predictors of preterm birth. Therefore, regular cervical length measurements are an essential part of prenatal follow-up.
Prediction and Management of Preterm Birth Risk
Today, several methods are available to assess the risk of preterm birth, such as:
- Measuring cervical length via transvaginal ultrasound
- Fetal fibronectin testing
- Evaluation of biochemical markers (such as PAPP-A) in screening tests
Early diagnosis allows for timely interventions that significantly reduce the likelihood of preterm delivery. In women with a previous history of preterm birth, progesterone therapy, cervical cerclage, and bed rest can help prolong pregnancy duration.
Conclusion
Preterm birth is one of the most significant complications of pregnancy. A comprehensive evaluation of medical causes, maternal risk factors, and biological processes is essential for ensuring a healthy pregnancy.
With regular check-ups, close monitoring, and appropriate treatments in high-risk situations, it is possible to reduce the rates of preterm birth and improve outcomes for both mother and baby.
