How a Premature Birth Impacts Future Pregnancies

Any infant born before a gestational age of 37 weeks is considered premature. Roughly 1 in 10 babies born in the U.S. is born prematurely. All babies born under 37 weeks have increased risks for complications; however, the risk is elevated the earlier a preterm birth occurs. 

There may be some hesitancy for women who are considering another pregnancy after delivering a premature baby – both for their own health and the health of their possible future infant.

Daniel Grace, MD, is a maternal and fetal medicine physician at our Perinatal Medicine office at Rochester General Hospital and explains the risks of premature births, and what patients can do to limit their risks of having a premature birth for future pregnancies.

Considering pregnancy after a premature birth

Women who give birth to a premature baby are more likely to have another preterm birth in the future. Prior preterm birth is the most significant risk factor for another preterm birth.

Some patients are more likely to deliver their second baby preterm, including

• Black, Native Hawaiian, Pacific Islander, American Indian, or Alaska Native women
• women with lower incomes
• women carrying multiple babies
• women who conceived using IVF

If you are considering having another child after having a premature baby, it is important to have a conversation with your OB/GYN about your personal health before you become pregnant again.

Your provider will want to take several factors into account, including pre-existing health issues like diabetes or hypertension to make sure they are well controlled. They will also review any medications you are taking to ensure that they are safe for a pregnancy.

Reducing the risk of premature birth

While it is not yet possible to eliminate the possibility of a preterm birth, there are many things that we can do to reduce the risk that a baby is born too soon.

Some risk factors for premature birth can be reduced by changing everyday habits, such as:

• quitting smoking
• avoiding substance use or drinking alcohol
• reducing stress
• getting regular exercise
• ideally delaying pregnancy for 18 months or more after a prior preterm birth

Regular prenatal visits: Continue to attend any prenatal care appointments and follow the advice of your medical provider.

Interventions in a future pregnancy: If you have had a prior preterm birth due to preterm labor or preterm rupture of membranes (breaking water preterm), then your provider will recommend checking the length of your cervix in any future pregnancy. The exact timing and frequency of checking the length of the cervix will depend on the timing of your prior preterm birth and your other risk factors.

Based upon those assessments, your provider may end up recommending use of vaginal progesterone to reduce the risk of preterm birth. Vaginal progesterone has been shown to reduce the risk of preterm birth for those with a short cervix found under 24 weeks of pregnancy. There are also situations in which your provider may recommend placement of a supporting suture in your cervix called a cerclage.

Wait until 39 weeks: Many women request to schedule labor inductions or cesarean sections based on convenience. It is important to wait until a gestational age of 39 weeks to consider any non-medically indicated delivery. While a baby after 37 weeks is considered full term, some babies born before 39 weeks will still need time to develop.

“Babies who are born before 39 weeks are more prone to breathing problems, difficulty eating, difficulty gaining weight, and problems keeping a warm body temperature,” Dr. Grace said.