Reducing the risk of premature birth

Each year in the U.S., nearly 1 in 10 babies is born prematurely (before 37 weeks of gestation). Preterm birth is the second-leading cause of infant death and increases a baby's risk for other health conditions.

Expectant parents can take an active role in reducing the risk of premature birth. Talk with your health care provider about what you can do. Steps might include improving nutrition, taking supplements (particularly folic acid), managing weight, starting an exercise program, checking vaccination status, and screening for sexually transmitted infections. Here are some other things you can do:

Treat chronic health conditions. Get treatment for any chronic health conditions like high blood pressure, diabetes, depression, and thyroid problems. 

Don’t consider an early elective delivery. Experts agree that delivery should be delayed until at least 39 weeks and that expectant mothers should be allowed to wait until 41 weeks before an induced delivery is considered.

Plan your pregnancies. Research has shown that subsequent pregnancies have better outcomes when mothers’ bodies are allowed to fully recover after a prior pregnancy. To reduce your risk of preterm labor, the Mayo Clinic advises waiting at least 12 months before becoming pregnant again. (For unknown reasons, waiting more than 5 years between pregnancies also seems to increase the risk of preterm birth.) Breastfeeding (on demand, 24 hours per day, exclusively) helps support adequate child spacing. Mothers who nurse frequently day and night using exclusive breastfeeding are more likely to suppress their menstruation and ovulation during the first 6 months after their baby’s birth. 

Follow best practices in fertility treatment. For women who undergo fertility treatment to become pregnant, the risk of preterm birth is reduced if they follow best practices that limit the number of fetuses carried during a single pregnancy.

Quit smoking before or during pregnancy. Smoking significantly increases a woman’s risk of preterm labor and the baby’s risk of low birth weight, congenital conditions such as cleft lip and palate, and sudden infant death syndrome (SIDS). 

Avoid alcohol and illicit drugs. Alcohol and drugs cross the placenta and may increase the risk of fetal growth impairment and preterm birth. The American Congress of Obstetricians and Gynecologists (ACOG), the National Organization on Fetal Alcohol Syndrome (NOFAS), and the March of Dimes continue to recommend that mothers avoid alcohol altogether during pregnancy. 

Consider progesterone treatment during pregnancy under some circumstances. Having a prior preterm birth or having a short cervix can increase the risk of preterm delivery. Progesterone treatments are available to treat these conditions, and women should discuss these options with their health care provider early in pregnancy if they are at high risk for a preterm birth. 

Consider low-dose aspirin to prevent preeclampsia in high-risk pregnancies. Rates of preeclampsia (a condition of pregnancy characterized by high blood pressure and protein in the urine that can cause dizziness, vomiting, swelling of the ankles and feet, and even seizures or death) have been increasing in the U.S. Treatment of this condition can require preterm delivery of the baby. The U.S. Preventive Services Task Force recommends that women who are at high risk for preeclampsia and under the supervision of a physician take a daily low-dose aspirin (81 mg per day) as a preventive measure starting as early as the second trimester.

Reduce your stress. Cut down on stress by doing something active every day, eating healthy foods, asking for help around the house, getting help if you’re in an abusive partnership, and talking to your boss about how to lower your stress at work. 

Addressing risk factors can make a big difference in reducing the chances of preterm birth. Since many of these steps are good for your health as well as your baby’s, you may experience improvements in your well-being that endure long after your pregnancy ends. 

Last updated March 2, 2021

Suggested Reads