Preterm Labor and Premature Birth Research
Health care providers consider labor to be preterm if it starts before 37
weeks of pregnancy. Because a fetus is not fully grown at 37 weeks, and it may
not be able to survive outside the womb, health care providers will often take
steps to stop labor if it starts before this time. Common methods for trying to
stop labor include bed rest and medications that relax the muscles in the uterus
involved with labor and delivery.
However, the American College of Obstetricians and Gynecologists (ACOG)
recently reported that many of the methods used to stop preterm labor are
ineffective. The ACOG announcement confirms NICHD-supported research, which
found that
home uterine monitors were not effective for predicting or preventing
preterm labor.
If efforts to stop labor fail, then the baby could be born prematurely.
Premature infants face a number of health challenges, including low birth
weight, breathing problems, and underdeveloped organs and organ systems. Many
infants that are born prematurely need to stay in the hospital until their
health is stable, sometimes several weeks or more.
NICHD Research on Preterm Labor and Premature Birth
Despite attempts to stop labor, many cases of preterm labor end in premature
birth. Premature birth occurs in between 8 percent to 10 percent of all
pregnancies in the United States; it remains one of the top causes of infant
death in this country. Infants who survive being born prematurely are at
increased risk for certain life-long health effects, such as cerebral palsy,
blindness, lung diseases, learning disabilities, and developmental disabilities.
Current NICHD-supported research is trying to identify markers and predictors
of preterm labor and premature birth. In one study, researchers are
investigating premature rupture of membranes (PROM), a situation in which the
membranes that support the fetus in the womb break (sometimes referred to as
"when a woman's water breaks") before the fetus is fully developed. PROM can
lead to preterm labor and premature birth. Researchers found that, in some
cases, the womb and the fetus produce enzymes, proteins that speed up certain
chemical reactions, which can cause the membranes to break apart. Further
research is now underway to figure out whether other features may make some
women more likely to experience PROM. The findings of this research may lead to
new methods of preventing PROM and some premature births.
Past research revealed that certain infections can make a woman more likely
to experience preterm labor and give birth early. For instance, women who have
bacterial vaginosis, the most common vaginal infection for women of reproductive
age, are more likely than other women to experience preterm labor and give birth
prematurely. Similarly, women who have trichomoniasis, a sexually transmitted
infection, are also more likely to give birth prematurely than women who don't
have the infection. It would stand to reason, then, that treating these
infections would prevent premature births in these cases. But, NICHD-supported
studies have shown that treating these infections is not an effective way to
prevent premature birth. Further research is now underway to find other options
for treating these infections that may reduce the risk of premature birth. For
more information on this research, read the
news release on the bacterial vaginosis and the
news release on trichomoniasis.
One effective way to understand preterm labor and premature delivery is to
study the characteristics of women who have given birth prematurely. One group
of NICHD-supported researchers found that, among women who had given birth
prematurely in the past, a shortened cervix could be a warning sign in preterm
labor for a current pregnancy. With this knowledge, scientists can work to
develop ways of preventing this shortening of the cervix, which may help to
prevent preterm labor and premature delivery. For more information on this
research, read the
news release about shortened cervix and premature birth.
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