Understanding the Causes of Preterm Labor | Healthline

If you're at risk for preterm labor, several diagnostic screenings can help you and your healthcare provider gauge how likely it is to occur. These assessments detect changes signaling labor onset and factors tied to higher chances of premature birth. They can be conducted before any symptoms appear or after labor has started.

Preterm birth happens when a baby is delivered before 37 weeks of pregnancy. Some preterm deliveries happen naturally, with labor beginning early on its own. In other cases, medical issues during pregnancy lead doctors to deliver the baby earlier than intended. Approximately 75% of preterm births occur spontaneously, while about 25% result from medical complications. Overall, nearly one in eight pregnancies end in early delivery.

Researchers are still exploring which tests or combinations best predict preterm labor risk. However, it's clear that the more positive screening results a woman has, the higher her likelihood of early delivery. For instance, a woman at 24 weeks pregnant with no prior preterm labor history, no current labor symptoms, a cervical length over 3.5 cm, and a negative fetal fibronectin test has less than a 1% chance of delivering before 32 weeks. Conversely, if she has a history of preterm birth, a positive fibronectin test, and a cervical length under 2.5 cm, her risk rises to 50% for delivery before 32 weeks.

What Causes Preterm Delivery?

Preterm delivery can stem from various factors. Sometimes labor begins early without an identifiable cause. Other times, medical conditions necessitate early delivery. The table below outlines common causes and the percentage of early deliveries attributed to each. Here, “preterm labor” refers to cases with no known cause.

Why Is Preterm Labor a Critical Concern?

Despite significant medical progress in caring for premature infants, nothing replaces the natural environment of the womb. Every extra week inside the uterus greatly improves a baby's chances of survival. For example:

• Babies born before 23 weeks generally cannot survive outside the womb.
• Between 24 and 28 weeks, survival rates improve dramatically — from about 50% at 24 weeks to over 80% by 28 weeks.
• After 28 weeks, more than 90% of babies survive independently.

Gestational age at birth also strongly influences the risk of complications:

• Infants born before 25 weeks face high risks of long-term issues, including learning and neurological disabilities; about 20% experience severe disabilities.
• Before 28 weeks, most babies encounter short-term challenges like breathing difficulties, with roughly 20% also facing long-term problems.
• Between 28 and 32 weeks, outcomes improve steadily. After 32 weeks, long-term complication risks drop below 10%.
• Full-term babies (after 37 weeks) rarely experience complications, though some may have mild issues such as jaundice or infections.

According to the March of Dimes, the average hospital cost for a preterm infant is $57,000, compared to $3,900 for a full-term newborn. In a 1992 study, total healthcare expenses for preterm births exceeded $4.7 billion. Nonetheless, advances in neonatal care have enabled many tiny babies to thrive and grow into healthy children.

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