Causes and Risk Factors - a quick look

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Although the cause of preterm birth is often unknown, expectant parents need not leave it purely to chance. There are a number of things a potential or expectant mother should and should NOT do, to limit the chances of preterm birth.


Healthy mother, healthy baby

The cause/s of preterm birth may be due to a number of very different events or triggers. Although there are a lot of risks identified there are no good predictors of preterm birth. This section is intended to give you a guide and a better understanding of the risks, some of which are easier to avoid than others depending on your personal circumstances.
Preemie help is here to help you identify any factors you may be able to avoid.


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A strong body of evidence exists suggesting that infection plays a role in the development of preterm labour and delivery. For example, infection around the cervix or uterus or systemic infections, such as pneumonia and malaria.

Infection Research

The data explaining the role of infection in preterm birth has been summarised within 3 lines of evidence

Animal Research

The first line of evidence stems from animal research in which several investigators discovered that the administration of bacteria or bacterial products to animals resulted in either abortion or preterm labour. A number of experimental studies, dating back to the 1940s, investigated the effects of administering a variety of endotoxins (e.g. salmonella, shigella, Escherichia coli) to animals, including mice, rabbits, and monkeys, and learnt that this resulted in abortion or preterm labour. A more recent study was able to induce preterm labour in rhesus monkeys by administering bacteria directly into the amniotic cavity or into the deciduas.

(Takeda & Tsuchiya, 1953; Zahl & Bjerknes, 1943; (Gravett, 1996)

Systemic Maternal Infections

The second line of evidence established an association between systemic maternal infections such as pneumonia, malaria, and typhoid fever and the onset of labour if untreated. The rate of preterm delivery associated with maternal pneumonia ranges from 15-48%.

(Romero, et al., 2001)(Madinger, 1989)

Intrauterine Infection

Thirdly, a large body of research has investigated the relationship between intrauterine infection with preterm labour and delivery. Intrauterine infections that have been associated with preterm birth and have been found to pose a significant increase in risk for preterm birth include sexually transmissible diseases (Chlamydia, syphilis, gonorrhoea), bacterial vaginosis, and microbial isolates (Fusobacterium, Mycoplasma). Intrauterine infection is estimated to account for 25-40% of preterm births. There is some evidence that suggests the earlier the gestational age women present with preterm labour, the higher the frequency of intrauterine infection.

(Goldenberg, Hauth, & Andrews, 2000; Romero, et al., 2001).(Andrews et al., 2000; Donders, Desmyter, De Wet, & Van Assche, 1993; Mikamo et al., 1999)

Technical Reference List

Andrews, W. W., Goldenberg, R. L., Mercer, B., Iams, J., Meis, P., Moawad, A., et al. (2000). The Preterm Prediction Study: association of second-trimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. American Journal of Obstetrics and Gynecology, 183(3), 662-668. Donders, G. G., Desmyter, J., De Wet, D. H., & Van Assche, F. A. (1993). The association of gonorrhoea and syphilis with premature birth and low birthweight. Genitourin Med, 69(2), 98-101. Goldenberg, R. L., Hauth, J. C., & Andrews, W. W. (2000). Intrauterine infection and preterm delivery. New England Journal of Medicine, 342, 1500-1507. Gravett, M. G., Haluska, G. J., Cook, M. J., Novy, M. J. (1996). Fetal and maternal endocrine response to experimental intrauterine infection in rhesus monkeys. American Journal of Obstetrics and Gynecology, 174, 1725-1733. Madinger, N. E., Greenspoon, J. S., Ellrodt, A. G. (1989). Pneumonia during pregnancy: has modern technology improved maternal and fetal outcome? American Journal of Obstetrics and Gynecology, 161(3), 657-662. Mikamo, H., Sato, Y., Hayasaki, Y., Kawazoe, K., Hua, Y. X., & Tamaya, T. (1999). Bacterial isolates from patients with preterm labor with and without preterm rupture of the fetal membranes. Infect Dis Obstet Gynecol, 7(4), 190-194. Romero, R., Gomez, R., Chaiworapongsa, T., Conoscenti, G., Kim, J. C., & Kim, Y. M. (2001). The role of infection in preterm labour and delivery. Paediatr Perinat Epidemiol, 15 Suppl 2, 41-56. Takeda, Y., & Tsuchiya, I. (1953). Studies on the pathological changes caused by the injection of the Shwartzman filtrate and the endotoxin into pregnant rabbits. Japanese Journal of Experimental Medicine., 21, 9-16. Zahl, P. A., & Bjerknes, C. (1943). Induction of decidua-placental hemorrhage in mice by the endotoxins of certain gram-negative bacteria. Proceedings of the Society for Experimental Biology and Medicine, 54, 329-332.



AlbertEinstein_iconOne of the greatest minds in history, Albert Einstein was born preterm.

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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 

Read More: Defining Preterm birth



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