Risks and Prevention of Future Premature Births

Preemie Baby in incubator looking at camera, sense of sight
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Having a premature baby presents a lot of physical and emotional challenges, so it's natural—if you're thinking of having another child—to wonder (and perhaps worry) about your risk for another premature birth. Learn about your risks and what you and your doctor can do to lessen them.

Risks of Additional Preterm Births

Previous preterm birth is one of the biggest risk factors for having another premature infant. The risk goes up when mothers have had more than one premature birth, and goes down when mothers have a term pregnancy after a preterm birth.

For spontaneous preterm deliveries:

  • A mom of one preemie has about a 15% chance of having another premature birth.
  • A mom who has had two preemies has about a 40% chance of having another premature birth.
  • A mom who has had three preemies has almost a 70% chance of having another premature birth.

These numbers only relate to moms who had a spontaneous preterm delivery. Mothers whose labors were induced early or who had a premature birth for health reasons were not included in these studies.

Mothers who had medically indicated preterm births are also at increased risk for future preterm births—due to the same medical issues that led to the first preterm delivery. One study from 2006 found the odds of preterm birth for mothers with a history of prior medically indicated preterm deliveries to be 2.5 times higher than those who had never had a preterm birth as opposed to 3.6 times more likely for those with a history of spontaneous preterm deliveries compared to the group with no history of preterm delivery.

Of course, while it's good for you to know the realities, you may not be hanging your decision to have another child on the official data. Doing what you can to reduce the risk is what you should focus on.

What You Can Do to Help Prevent a Subsequent Premature Birth

Although the risk of another preemie is significant, having one preemie doesn't mean that you will absolutely have another. Many risk factors can be reduced or eliminated before you decide to try again:

  • Wait to conceive: If you've had a preemie, experts recommend waiting at least 18 months before trying to conceive again. The risk of having a second preemie is higher when pregnancies are closer together, and lower when they are farther apart.
  • Stop smoking: Smoking cigarettes increases the risk of premature birth. Quitting smoking during pregnancy or before conception is one of the best ways to reduce your risk of having another premature birth.
  • Treat infection early: Inflammation and infection play a role in premature birth. The exact relationship is unclear, but experts agree that any bacterial infections during pregnancy should be treated early. Antibiotics for non-symptomatic infections, though, are not recommended.
  • Avoid yo-yo dieting: Women who lose a large amount of weight between pregnancies have a greater risk for premature birth during the second pregnancy. Women with a body mass index of less than 19.8 kg/m2 are also at a higher risk of preterm delivery, so maintain a healthy weight.
  • Manage other health conditions: Diabetes, high blood pressure, heart disease, and kidney disease all increase the risk of premature birth. Better management of these conditions can lower the risk.

Doctor Intervention

Unfortunately, medical science has not found a sure way to prevent 100% of premature births. Over the past few years, though, much research has been done on how to detect, prevent, and stop preterm labor, and some reassuring findings have been reported:

  • Detection: Recent discoveries have helped doctors' ability to tell whether a woman is at risk for imminent preterm delivery. Cervical ultrasound has great success in detecting early signs of preterm labor, and it can be used as early as 16 weeks. Other studies of the mother's blood and vaginal secretions can help predict the risk more accurately.
  • Prevention with progesterone: Weekly shots of the hormone progesterone can help prevent premature birth in mothers who have had one preterm birth already. Injections are usually started between the 16th and 20th week of pregnancy, and continue until 37 weeks.
  • Prevention with cerclage: A cerclage, or a stitch in the cervix, has been used for many years to prevent premature birth in women who have had one preterm delivery. Studies show that cerclage may be helpful, and more studies are underway.
  • Prevention with bed rest and medication: Although doctors commonly prescribe bed rest and medications to women who show signs of preterm labor, research has not yet found that either does much to prevent premature birth. More studies are underway.

Knowing exactly what the risks of premature birth are and how doctors can prevent or stop premature can make the choice to get pregnant again a little easier.

5 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ahumada-Barrios ME, Alvarado GF. Risk Factors for premature birth in a hospitalRev Lat Am Enfermagem. 2016;24:e2750. doi:10.1590/1518-8345.0775.2750

  2. Ananth CV, Getahun D, Peltier MR, Salihu HM, Vintzileos AM. Recurrence of spontaneous versus medically indicated preterm birth. Am J Obstet Gynecol. 2006;195(3):643-50. doi:10.1016/j.ajog.2006.05.022

  3. Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes. Mortality and Acute Complications in Preterm Infants. In: Behrman RE, Butler AS, editors. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: National Academies Press (US); 2007.

  4. Newnham JP, Dickinson JE, Hart RJ, Pennell CE, Arrese CA, Keelan JA. Strategies to prevent preterm birthFront Immunol. 2014;5:584. doi:10.3389/fimmu.2014.00584

  5. Cook JR, Chatfield S, Chandiramani M, et al. Cerclage position, cervical length and preterm delivery in women undergoing ultrasound indicated cervical cerclage: A retrospective cohort studyPLoS One. 2017;12(6):e0178072. doi:10.1371/journal.pone.0178072

Additional Reading
  • Centers for Disease Control and Prevention. "CDC Features: Premature Birth."http://www.cdc.gov/Features/PrematureBirth

  • Esplin, MD, Michael S., O'Brien, Ph.D., Elizabeth, Fraser, MPH, Alison, Kerber, PhD, Richard A., Clark, MD, Erin, Simonsen, RN, MSPH, Sara Ellis, Holmgren, MD, Calla, Mineau, PhD, Geraldine P., Varner, MD, Michael. "Estimating Recurrence of Spontaneous Preterm Delivery." Obstetrics and Gynecology Sept 2008 112:516-523. 

  • Medline Plus Medical Encyclopedia. "Premature Infant." http://www.nlm.nih.gov/medlineplus/ency/article/001562.htm

  • Spong, MD, Catherine Y. "Prediction and Prevention of Recurrent Spontaneous Preterm Birth." Obstetrics and Gynecology August 2007 110:405-415.

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.