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Know the risks, prevent preterm labor

Getting pregnant is usually reason for great optimism. It’s the opportunity to bring new life into the world, express the joy of a committed relationship and fulfill one of life’s most elemental goals.

Every pregnancy is, by definition, life-changing. While being pregnant certainly isn’t easy, most pregnancies are completed just as nature intended, with delivery as expected and everyone healthy. However, every now and then, things don’t quite go according to plan. Sometimes, your new baby will be in a rush to get into the world, and be born prematurely, which can cause health issues.

“Premature birth is a serious concern,” said Corinna Muller, DO, an OB-GYN and maternal-fetal medicine specialist at Geisinger. “When a baby is born premature it may face short-term problems like having trouble regulating body temperature, breathing problems, bleeding in the brain and low blood pressure, or long-term problems like developmental disabilities, cerebral palsy, vision problems and other lifelong chronic health issues.”

Premature birth rates have gone up 28 percent since 1981. According the National Center for Health Statistics, one in eight babies will be born prematurely. Some experts point to fertility treatments and the fact that many women have children at an older age and have more medical problems that can complicate pregnancy when they become pregnant later in life. However, there are other less-known contributors to premature birth.

Here are three causes you probably haven’t heard of:

Nutritional status
It is important to prepare for pregnancy by having a healthy body mass index (BMI). Premature birth risk can be increased in both mothers who are obese and mothers who are underweight. Preconceptual dietary counseling is advised in patients who are trying to conceive to help them reach a healthy BMI with diet and lifestyle changes.

When you’re pregnant, your baby gets nutrients from what you eat. But babies have different nutritional needs than adults, and making sure that your baby gets enough nutrients can help prevent premature birth.

Folic acid is an important supplement for brain and central nervous system development in babies, and most people know it as a way to prevent spina bifida. Folic acid can also help decrease the risk for other pregnancy complications like placental abruption and preeclampsia — two conditions responsible for about 20 percent of indicated premature births. Babies with congenital malformations are also at risk for preterm delivery.

Folic acid can be found in vitamin supplements as well as foods like spinach, beans, bread and oranges.

However, since it’s most important to get folic acid in the first 12 weeks of pregnancy during the formation of the fetal central nervous system (and other major organ systems), women should preemptively take folic acid supplements daily or a daily multivitamin containing folic acid for at least three months before pregnancy.  About half of pregnancies are unplanned, so supplementation can help ensure that new babies get enough folic acid in the critical first month.

As soon as you find out you’re pregnant, talk to your doctor about how your diet and nutrition should change and ways to achieve a healthy BMI.

It’s long been known that sexually transmitted infections like gonorrhea or chlamydia can increase someone’s risk for preterm labor. Untreated urinary tract infections can also increase a woman’s risk for preterm delivery, so routine prenatal care is recommended as early as possible in pregnancy.

“When you get an infection, your body sends out chemical messengers,” said Dr. Muller. “This is normal and part of a healthy immune system. However, when you’re pregnant, these chemical messengers are the same ones that trigger contractions and birth. If you have an infection, talk to your doctor about antibiotics—they may be able to treat the infection. If you’re prone to certain infections, ask your doctor about ways that you can prevent future infections.”

Poor dental care
When you find out you’re pregnant, the last thought that may cross your mind is, “I better go see my dentist!” But studies show that gum disease and other dental problems can have a profound effect on premature birth.

In one study, 366 women received thorough dental cleanings above and below the gums. In this group, there was an 84 percent drop in premature birth risk.

“Aside from routine dental cleaning appointments, it’s important to be sure that expectant mothers brush twice every day and floss after every meal,” said Dr. Muller. “Talk to your dentist about your risk of gum disease and what you can do to prevent it. It’s likely that gum disease is similar to infections when it comes to premature birth. The inflammation from gum disease releases the same chemical messengers, which may explain the link to premature birth.”

Corinna Muller, DO, is an OB-GYN and a maternal-fetal medicine specialist at Geisinger Maternal Fetal Medicine in Forty Fort. To schedule an appointment, please call 800-275-6401.