Updated October 2013

Reducing the risk of premature birth

What you can do to reduce your risk of premature birth

It's not easy for the healthcare team to discover why some babies are born prematurely, but there are steps that can be taken that can slightly reduce your risk of premature birth.

Premature birth and managing your weight

Overweight or underweight? You're more likely to develop complications that could contribute to your baby being born prematurely. To reduce this risk, learn how to manage your weight healthily.

Premature birth and staying active

Being physically active throughout pregnancy will boost your overall wellbeing and reduce your risk of conditions such as diabetes and pre-eclampsia, which can lead to premature birth.

Unless you've been advised otherwise due to specific health problems, it's a good idea to do something active every day. This doesn't have to involve organised exercise, such as an antenatal fitness class: any activity you do in your daily routine counts, including walking. Find out more about staying active in pregnancy here.

Please note: If you have been diagnosed with any of the following conditions associated with premature birth, please consult with your healthcare team before starting a new exercise plan or embarking on activity:

Premature birth and your mental health

Women who are stressed or depressed seem to be at higher risk of giving birth prematurely, but it's not clear why. It could be because they are less likely to lead healthy lifestyles.

Well-being is difficult to assess - not least because we all have different stress thresholds - but many factors linked with depression have been linked with premature birth too.

Find out more about looking after your mental health during pregnancy.

Premature birth and smoking

Cutting down or stopping smoking is one of the most positive steps you can take to reduce the risk of your baby being born prematurely.

Smoking is clearly linked with premature labour, and the more you smoke the more likely you are to have your baby prematurely.

Find out more about pregnancy and smoking here.

Premature birth and alcohol

Drinking alcohol during pregnancy is known to be a risk factor in causing premature birth. Giving up completely is safest, but if not, alcohol intake should be limited to one or two units once or twice a week.

Find out more about alcohol and pregnancy here.

Premature birth and drugs

Taking drugs when you're pregnant can harm your baby and could increase the risk of premature delivery, so seek help to stop now.

Recreational drugs

Taking substances such as cannabis, cocaine and heroin could harm you or your baby during pregnancy. Women who use recreational drugs such as ecstasy often stop once they realise they are pregnant, while women who have drug dependency may carry on using throughout the pregnancy.

Why drugs are dangerous

It's not just the chemical content of the drug that can increase your risk of premature delivery. Because drugs can enhance mood or alter your perceptions, they can impair your judgement and result in you making lifestyle choices that can increase your risk of premature delivery. Other risks include withdrawal for your baby after birth and other health and developmental problems.

Other medicines and remedies

If you use any medication, always check first that it is safe to use when pregnant. Even some painkillers such as ibuprofen are not recommended during pregnancy.

These medications are usually safe during pregnancy:

  • paracetamol
  • most antibiotics
  • local anaesthetic
  • flu vaccination.

When to seek advice:

  • If you are using medication for any long-term conditions, ask your pharmacist or healthcare team about your treatment options.
  • If you are using any other legal drugs without a prescription, for example if you are dependent on painkillers or sedatives, you could be doing serious harm to your baby, so seek advice as soon as possible.

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Premature birth and infection

Many types of infection are associated with premature birth. Some infections can have specific effects on a pregnant woman or her baby, but any infection can compromise your immune system, making you more susceptible to further health problems for you or your baby. Find out more about the infections associated with premature birth.

How to protect yourself from infections and viruses

Get treatment for sexually transmitted infections (STIs). STIs such as chlamydia, gonorrhoea, syphilis and genital herpes may affect your baby. If you think you or your partner have an STI, talk to your healthcare team or go to a confidential genitourinary (GUM) or sexual health clinic.

Seek advice about HIV. This can be transmitted through sexual contact or sharing needles if you inject drugs. Even if you are carrying the HIV virus, the right treatment can greatly reduce the chances of it being passed to your baby. If you are in any doubt, get a test and talk to your healthcare team.

Avoid animal-borne infections

  • Always wash your hands after touching animals or their bodily fluids.
  • If you have a cat, avoid contact with their poo, for example, when changing the litter tray, as it can carry the bacteria that cause toxoplasmosis, which can be harmful to your baby.
  • Wear gloves when gardening in case there are traces of cat poo in the soil.
  • Avoid contact with sheep, pigs and rodents.

Prevent food poisoning

  • Follow NHS guidance on foods to avoid during pregnancy, as some contain bacteria that could cause health problems.
  • Be careful when you are preparing, storing or eating food: wash your hands thoroughly before and after touching food; don't eat foods beyond their use-by date; and disinfect any utensils or surfaces touched by raw meat or fish.

Improve general hygiene. Pay more attention than usual to washing your hands after going to the loo, before eating, after changing nappies and before touching your mouth.

Look after your teeth and gums. It might sound odd, but scientists have found a link between tooth decay, gum disease and premature birth, suggesting that inflammation and infection in the gum may be associated with premature labour. The experts agree that this probably does not directly cause premature labour, but it's another good reason to practise good oral hygiene. If you have dental problems during pregnancy it is worth mentioning them to your healthcare team. Dental care is free when you're pregnant, so take the opportunity to keep your mouth in tip-top condition.

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The following organisations can give you more information about the topics covered in this section.


Sources

BMJ Best Practice (2011) Premature newborn care, basics, aetiology, http://bestpractice.bmj.com/best-practice/monograph/671/basics/aetiology.html

Henderson D, Macdonald S (2004) Mayes Midwifery (13th edition), London, Balliere Tindall

Dayan J, Creveuil C, Marks MN (2006) Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care, Psychomatic Medicine, Pub Med, Nov-Dec;68(6):938-46. Epub 2006 Nov 1.

BMJ Clinical Evidence (2011) Premature newborn care, diagnosis, history and examination, http://bestpractice.bmj.com/best-practice/monograph/671/diagnosis/history-and-examination.html

Jeffcoat M, Parry S, Sammel M et al (2010) Periodontal infection and preterm birth: successful periodontal therapy reduces the risk of preterm birth, British Journal of Obstetrics and Gynaecology, http://dx.doi.org/10.1111/j.1471-0528.2010.02713.x.

Anderson BL, Juliano LM, Schulkin J (2009) Caffeine's implications for women's health and survey of obstetrician-gynecologists' caffeine knowledge and assessment practices, 'Journal of Women’s Health', Vol 18, No 9, p1457-66

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Managing your weight

Staying active

Your mental health

Smoking

Alcohol

Drugs 

Infection



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DID YOU KNOW?

High caffeine use has been linked to low birth weight and miscarriage, so try to limit it to about 200mg a day. That's two mugs of tea or instant coffee, one mug of filter coffee, two cans of energy drink, five cans of cola, 200g of dark chocolate or twice as much milk chocolate.

TIP

For free advice, information and treatment facilities for drug and alcohol problems, ask your GP to refer you to your local Drug and Alcohol Action Team (DAAT), or contact them directly by typing the name of your local authority and 'DAAT' into your search engine. Most have pregnancy specialists on hand to give you tailored support.