About Pre-Term Labour

In western societies as many as one in ten pregnant women go into labour before their pregnancy has reached the full term of 40 weeks.

Normally defined as labour occurring before 37 weeks of pregnancy, pre-term, or premature, labour usually poses little risk for the mother but the negative health consequences for the baby can be enormous.

Amazing advances have been made in neonatal care over the last two decades, enabling very premature babies, as early as 22 to 24 weeks to survive. But those who do survive continue to face certain problems. Some are relatively straightforward such as learning difficulties, while others are more severe and better avoided, such as respiratory disorders or cerebral palsy.

About a third or more cases of pre-term labour occur for no apparent reason though experience has shown that some groups of women are likely to be at a higher risk than others.

Women at risk

Very young women, older women (in their 40s), women who have had frequent pregnancies, those who are carrying more than one baby, women who are underweight or have a poor diet and those who smoke are all known to be at risk of premature deliveries.

Other cases of pre-term labour are associated with medical conditions. A condition known as pre-eclampsia is behind a third of all premature births. The condition creates a sudden and severe rise in blood pressure and is directly linked to pregnancy, affecting about 1 in 14 pregnant mothers.

An incompetent cervix, one that is weak and unable to remain closed under the weight of a growing baby, can also lead to a premature delivery, as can many vaginal infections. Also, stressful events such as long distant air travel, the death of a relative or close friend and moving house late in pregnancy may cause a woman to go into labour before full term is reached.

Potential risk to the baby

Premature babies are small and underdeveloped. They are at serious risk of death and a range of complications, with the risk being greater the smaller and earlier they are. The degree of prematurity is also linked to long-term development problems of the child.

The two major risks for babies being born before 32 weeks are lack of surfactant in the lungs (the ‘wetting’ agent that stops the lungs from sticking together allowing them to expand) and low blood sugar.

Babies born after 34 weeks only have a low risk of problems because their systems have almost completely matured. Babies born after only 23 to 24 weeks of pregnancy are at most risk of both short and long-term problems.

So it is important to maintain the pregnancy as long as possible to give the new-born baby the best chance in life as possible.

Treating pre-term labour

Pre-term or premature labour remains a problem all over the world. Despite the advances in the care of premature babies, there has been little improvement in reducing the number of women who go into labour early.

Much can be done to help halt an unwanted labour and delay birth by using today’s modern medicines, which prevent uterine contractions (tocolysis). Ferring’s TRACTOCILE (atosiban) is the latest treatment doctors use everyday to delay premature birth and improve the health and safety of mother and baby.

Until TRACTOCILE became available there were few approved treatments to prevent an early labour. TRACTOCILE is considered a real breakthrough in this area, working within the natural processes of labour to counter the action of oxytocin effectively with a good safety profile, switching off the contractions developing throughout the uterus.

Future approaches

The real challenge with pre-term labour is to spot it before it gets going. Thus, researchers are always looking for ways to interrupt the processes involved in labour by identifying the triggering chemical messengers and processes.

It will eventually be possible to identify those women most at-risk of going into labour early and use medications to turn off the premature delivery before it actually begins.

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