Preventing Premature Births
Every day 1 in 8 babies born in the U.S. arrives too soon. Premature birth can happen to any pregnant woman, and no one knows why. It is a serious, common and costly problem.  

The March of Dimes is leading the campaign to reduce premature birth by  supporting research and by educating the public and health care providers.

Preventing Premature Births

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Prematurity has been escalating steadily and alarmingly over the past two decades. Between 1981 and 2002, the rate of premature births rose from 9.4 percent to 12.1, an increase of more than 29 percent. Every year more than 470,000 infants are born prematurely. That's roughly comparable to the population of New Orleans or Cleveland.

Preterm delivery can happen to any pregnant woman. It's happening more and more often. And, in nearly half the cases, no one knows why.

Current Prematurity Facts
Today 1,300 babies in the U.S. will be born prematurely. Many will be too small and too sick to go home.  Instead, they face weeks or even months in the neonatal intensive care unit (NICU), with their frightened parents looking on helplessly. These babies face an increased risk of death and serious medical complications; however, most, eventually, will go home.

But what does the future hold for these babies?  Many survivors grow up healthy; others arenít so lucky. Even the best of care cannot always spare a premature baby from lasting disabilities such as cerebral palsy, mental retardation and learning problems, chronic lung disease, and vision and hearing problems.  Half of all neurological disabilities in children are related to premature birth.

While doctors have made tremendous advances in caring for babies born too small and too soon, we need to find out how to prevent these tragedies from happening in the first place. Despite decades of research, scientists have not yet developed effective ways to help prevent premature delivery. In fact, the rate of premature birth increased 29 percent between 1981 and 2002 (9.4 to 12.1 percent). 
Why Do Women Deliver Early?
In nearly half of premature births, the cause is unknown.  However, researchers have made some progress in learning the causes of prematurity. Studies suggest that there may be four main routes leading to premature labor.
  1. Maternal or fetal stress.  Chronic psychosocial stress in the mother or physical stress (such as insufficient blood flow from the placenta) in the fetus appears to result in production of a stress-related hormone called corticotropin-releasing hormone (CRH).  CRH may stimulate production of a cascade of other hormones that trigger uterine contractions and premature delivery.
  2. Infections.  Studies suggest that premature labor is often triggered by the bodyís natural immune response to certain bacterial infections, such as those involving the genital and urinary tracts and fetal membranes.  Even infections far away from the reproductive organs, such as periodontal disease, may contribute to premature delivery.
  3. Bleeding.  The uterus may bleed, due to problems such as placental abruption (when the placenta peels away, partially or almost completely, from the uterine wall prior to delivery).  Bleeding triggers the release of various proteins involved in blood clotting, which also appear to stimulate uterine contractions.
  4. Stretching.  The uterus may become overstretched by the presence of two or more babies, excessive amounts of amniotic fluid, or uterine or placental abnormalities, leading to release of chemicals that stimulate uterine contractions.

The finding that there are several routes that can result in premature delivery may help explain why prematurity is so difficult to prevent.  Now that scientists have a better handle on possible pathways to prematurity, they may be able to develop more effective interventions that can halt the various chemical cascades that lead to it.  But first they must identify the women who need these treatments.

For more information, visit The March of Dimes

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