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Risks Factors for Premature Birth

What Are Your Chances of Having a Preemie?


Updated June 11, 2014

premature baby

Carrying twins, triplets or high-order multiples can put you at risk for having a premature baby.

Image © Jessica Redden
Thinking about risks for having a premature baby and how to prevent them aren't always at the top of a new mom's to-do list when the pregnancy test turns positive. When you find out that you’re expecting a baby, there are much more exciting plans to make! Choosing nursery decorations, registering for baby equipment, narrowing down name choices, and planning coming home parties are all part of the thrill of being pregnant.

Planning for a healthy pregnancy is another important part of expectant motherhood. Premature birth is a major health problem, and one that is increasing. Because preterm birth is such a problem, scientists are working hard to figure out who is most at risk, how to diagnose preterm labor as early as possible, and how to prevent birth when labor starts early. So, talk to your doctor or midwife about your risk factors and what you can do to reduce or eliminate the risks, which include:

  • Previous premature birth: Having one premature baby puts you at increased risk for having another preemie. The risk increases if pregnancies are close together or if you have additional risk factors. Controlling other risk factors can help reduce the risk of having a second preterm birth.

  • Multiple pregnancies: Mothers carrying multiples (twins, triplets, or more) are at an increased risk for early delivery, as well as other potential risks. Learning more about carrying multiples can help you work with your doctors to ensure a safe and healthy pregnancy.

  • Uterine or cervical problems: Uterine infections, incompetent cervix, and placental abruption can all cause preterm labor and birth. Treatment differs based on the problem, and may include bed rest, cerclage, medication, or an early delivery.

  • Chronic high blood pressure: Having high blood pressure before conception gives you a higher risk for early birth. Preeclampsia also increases the risk. Early prenatal care can help doctors and midwives to diagnose and treat preeclampsia or other hypertensive disorders of pregnancy early, reducing the risk of complications.

  • Diabetes: If you had type 1 or type 2 diabetes before pregnancy, you are more likely to deliver your baby early. Good blood sugar control can be hard to maintain during pregnancy, even in women who have been well-controlled for many years. Keeping blood sugars within a healthy range can reduce the risk of premature birth and other risks of diabetes during pregnancy.

  • Cigarette smoking: Smoking cigarettes is one of the greatest risks of premature delivery, and one of the most controllable. Aside from the risk of premature birth, there are many other reasons to quit smoking during pregnancy.

  • Alcohol use: Premature birth is among the many risks associated with drinking alcohol during pregnancy. Remember that no amount of alcohol is safe while you are pregnant.

  • Age: Mothers under age 18 and over 30 have a greater risk of going into labor early than other mothers. Reducing other risk factors is essential if your age puts you at an increased risk for premature birth.

  • Lack of prenatal care: The later your prenatal care begins, the greater your risk of health problems during pregnancy. Lack of and delayed prenatal care are associated with preterm delivery. So, make a doctor’s appointment as soon as you find out that you are pregnant.

  • Poor nutrition: Mothers with an extremely low body mass index have a higher risk of preterm delivery. Mothers with a generally poor nutritional status also have a greater risk. To reduce the risk, maintain a healthy weight and avoid yo-yo dieting.

  • Untreated infection: Infections, especially uterine and urinary tract infections, can increase the risk of premature birth. In fact, a high white blood cell count (a marker of infection) is the best predictor of preterm birth at 22 to 27 weeks gestation.


Esplin, MD, Michael S., O’Brien, PhD, 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 W. “Estimating Recurrence of Spontaneous Preterm Delivery.” Obstetrics and Gynecology Sept 2008 112:516-523.

Hill, MSca, Jacquelyn L., Cambell, PhDab, Karen, Zou, PhDa, Guang Yong, Challis, PhDd, John R.G., Reid, PhDc, Gregor, Chisaka, MDde, Hiroshi, and Bocking, MDd, Allen. “Prediction of Preterm Birth in Sypmptmatic Women Using Decision Tree Modeling for Biomarkers." American Journal of Obstetrics & Gynecology April 2008 198:e1-e9.

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

Centers for Disease Control and Prevention. "CDC Features: Premature Birth." Accessed: October 1, 2008. http://www.cdc.gov/Features/PrematureBirth/.

Medline Plus Medical Encyclopedia. "Premature Infant." Accessed: October 1, 2008 http://www.nlm.nih.gov/medlineplus/ency/article/001562.htm.

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  4. Causes of Premature Birth
  5. Causes and Risk Factors for Preterm/Premature Birth

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