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HOME/Rare and Complex Conditions/Questions to Ask Your Doctor About Prematurity

Questions to Ask Your Doctor About Prematurity

Questions to Ask Your Doctor About Prematurity
November 17, 2018
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By: Louis Muglia, MD, PhD

If you’re pregnant or thinking about becoming pregnant, you’re probably aware of how common premature birth is. Every year in the United States, 380,000 babies are born prematurely, or when a baby is born before 37 weeks of gestation.

This is an issue because premature babies can face more short- and long-term health problems, such as vision, hearing, brain, and lung issues.

A recent study found that as many as 25% of preterm births might be attributed to three risk factors: the spacing between pregnancies, the mother’s body mass index (BMI) prior to pregnancy, and the amount of weight gain during pregnancy. All of these risk factors may be modifiable to reduce the risk of premature birth.

So if you are pregnant, or thinking about becoming pregnant, you might be wondering what you can do to avoid this situation. Speaking with your doctor about it is a great first step. Here are six questions you can ask to help guide your conversation:

Before Pregnancy:

  1. How will my current weight affect my future pregnancy? We know that having either a high BMI or a low BMI going into pregnancy can negatively affect it. If your weight is too low before pregnancy, you might not have enough nutritional reserves to support the pregnancy. And if you have a high BMI, it increases the chances of developing high blood pressure and diabetes during pregnancy.
  2. I’ve been pregnant before. How long should I wait before I have another one? We know that lack of sufficient spacing between pregnancies is a risk factor for preterm birth. Mothers need to wait at least 12-24 months between the birth of the previous baby and conceiving the next one. This spacing allows the mother to fully recover, as significant nutritional resources go into supporting the maternal system.
  3. My last pregnancy resulted in a preterm birth. How can I avoid this situation next time? We know that having one preterm birth means that you are more likely to have another one. Ask your doctor what risk factors you had last time that you might be able to modify this time around. Also, inquire if progesterone supplementation is a good option for you.
  4. I read that African American women are at an increased risk of having a preterm birth. What can I do? The reasons why African American women are at an increased risk are unclear. What we do know is that this happens regardless of socioeconomic status. So it is especially important to modify the risk factors that they can control – weight before pregnancy, weight gain during pregnancy, and spacing between pregnancy.

During Pregnancy

  1. What can I do to have a healthy pregnancy? Aside from maintaining a healthy weight, not smoking and taking prenatal vitamins, your doctor will likely tell you how important it is to attend all of your prenatal visits. This allows him or her to keep an eye on how the pregnancy is progressing and to watch out for any potential issues.
  2. Should I have my cervical length screened around 20 weeks? We know that women with a short cervix have a 50% chance of preterm birth. If your doctor finds that you have a short cervix, he may suggest that you have progesterone supplementation to prevent prematurity. Screening for cervical length is not recommended for everyone, but your doctor can evaluate whether it’s appropriate for your situation.

Having answers to these questions can help you and your doctor work as a team to prevent the modifiable risk factors of preterm birth. If you’d like to learn more about maintaining a healthy pregnancy and avoiding prematurity, there are great resources online and in your community. The March of Dimes has a wealth of knowledge on their website. And locally, Cradle Cincinnati has resources available to help moms, dads and babies.

We offer a one-time, familial preterm birth clinic for women at risk of preterm birth before they become pregnant or in early pregnancy (less than 24 weeks). For more info, visit our  webpage or call 513-636-3882.

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About the author: Louis Muglia, MD, PhD

Louis Muglia, MD, PhD, is the co-director of the Perinatal Institute, director of the Center for Prevention of Preterm Birth and a pediatric endocrinologist at Cincinnati Children’s. His clinical and research interests are related to understanding the genes and molecular pathways that predispose a pregnancy to end prematurely, how a family’s environment during pregnancy modifies this risk, and providing optimal counseling to families, and together with maternal-fetal medicine specialists, how to increase the likelihood of having a healthy pregnancy.

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