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Perinatal Health

Preterm Birth

Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. A full term pregnancy is 40 weeks. In 2015, preterm birth affected about one of every 10 infants born in the United States. Preterm birth rates decreased from 2007 to 2014, and CDC research shows that this decline is due, in part, to declines in the number of teen. Racial and ethnic disparities play an important role of preterm births. In 2015, the rate of preterm birth among African-American women (13%) was much higher than the rate of preterm birth among white women (9%).

A developing baby goes through important growth throughout pregnancy. The brain, lungs, and liver need the final weeks of pregnancy to fully develop. Read Your Baby Grows Throughout Your Entire Pregnancy. There is a higher risk of serious disability or death when the baby is born too early. In 2013, about one third (36%) of infant deaths were due to preterm-related causes. Babies who survive may have:

Some premature babies require special care and may spend weeks or months in special care units or neonatal intensive care units.  For infants with developmental delay, caretakers should schedule neuro-developmental assessments at regular intervals and provide interventional care done to minimize neurological sequelae.  Preterm birth may also take an emotional toll and cause a financial burden to families. 

Risk Factors For Preterm Birth

Many times we do not know what causes a woman to deliver early, but several known factors may increase the likelihood that a woman delivers early. This preterm birth infographic gives some examples of these factors by medical and pregnancy conditions, behavioral factors; and social, personal, and economic characteristics. 

Warning Signs For Preterm Labor

In most cases, preterm labor begins unexpectedly and the cause is unknown. Like regular labor, signs of early labor are:

  • Contractions (the abdomen tightens like a fist) every 10 minutes or more often
  • Change in vaginal discharge (a significant increase in the amount of discharge or leaking fluid or bleeding from the vagina)
  • Pelvic pressure—the feeling that the baby is pushing down
  • Low, dull backache
  • Cramps that feel like a menstrual period
  • Abdominal cramps with or without diarrhea

Call your health care provider immediately or go to the nearest delivering hospital if you experience any of these symptoms.

Risk Reduction For Preterm Birth

Preventing preterm birth remains a challenge because there are many causes of preterm birth, and causes may be complex and not always well understood. However, pregnant women can take important steps to help reduce their risk of preterm birth and improve their general health. These steps are:


The CDC has determined that the majority of infants born prematurely, regardless of birth weight, should be vaccinated with the same dose(s), at the same chronological age and according to the same schedule and precautions as full-term infants and children.

Children should receive their first immunizations two months after birth. The one immunization that a premature infant may not receive on schedule is the hepatitis B vaccine, which is usually given at birth. This vaccine is not effective in very small infants and is not given until an infant weighs at least 2,000 grams.

Respiratory Syncytial Virus (RSV)

Preterm babies are at elevated risk for RSV. Those who are born under than 32 weeks are at even greater risk for severe RSV disease due to the lack of full development of their lungs and immune responses. Small preemies are more likely to develop subsequent issues associated with chronic or recurring lung disease.

Family members can help prevent babies from contracting RSV by understanding how it's acquired and taking these steps:

  1. Avoid exposure. The best way to protect against RSV is to make sure other children and adults with cold symptoms stay away from the baby.
  2. Keep it clean. This virus can survive on surfaces for several hours. It thrives on countertops and tissues. Family members should avoid touching these surfaces, then handling the baby or objects, such as toys or bottles used for the child. Otherwise, the virus can infect the baby through his or her eyes and nose. It is important to keep toys and personal items as clean as possible. Anyone who comes in regular contact with the child should take the time to wash his or her hands or use antibacterial gels often.
  3. Assess the risk. If the baby was premature, it is important to check with his or her pediatrician to see if the child is at higher risk than normal for RSV. The doctor also should go through all the options to help protect the baby from the virus.
  4. Monitor the baby. Family members should be on the lookout for any persistent coughing, wheezing or difficulty breathing and contact a pediatrician if observed.
  5. Trust your instincts. Parents or other family members who are the primary caretakers almost always know their baby better than anyone else. If the baby looks somehow "off" to you - appears lethargic, acts different, or has trouble feeding - don't hesitate to dial the pediatrician's number.

Rsv Prophylaxis And High Risk Groups

Palivizumab is a monoclonal antibody recommended by the American Academy of Pediatrics (AAP) to be administered to high-risk infants and young children likely to benefit from immunoprophylaxis based on gestational age, certain underlying medical conditions, and RSV seasonality. It is given in monthly intramuscular injections during the RSV season, which generally occurs during fall, winter, and spring in most locations in the United States.

On July 28, 2014, AAP released updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for RSV infection. For specific and the latest palivizumab guidance, please consult the AAP policy statement. An accompanying AAP technical report provides additional context and rationale for the guidance.