The life-changing research helping all mums-to-be

Do you know the potential dangers of your baby being born too soon?

For any mum-to-be, understanding preterm birth – being born too soon –and how to prevent it from happening should be a top priority. This is because in Australia today, preterm birth is the leading cause of early childhood death and disability. These disabilities include cerebral palsy, deafness, blindness and learning and behavioural problems.

Research shows us that more than 26,000 Australian babies are born too soon each year, and more than 15 million worldwide. Once these preemie babies are born, they require a raft of life saving technology not only to survive, but thrive. However, it can be prevented; preterm birth isn’t predetermined at birth or in the womb.

This information isn’t new to those who work in the field. They know that learning how to prevent it from happening and then evaluating the impact of that effectiveness needs to be one of the highest priorities in healthcare today.

Back in 2014, experts right here in Western Australia pioneered a program which saw the rate of preterm births fall across the state by 7.6 per cent, and by 20 per cent at King Edward Memorial Hospital. This provided the catalyst to continue the lifesaving research and helped spread awareness of the implementation of key interventions for safer pregnancies for all women and their babies.

Spurred by the success, the Australian Preterm Birth Prevention Alliance was created in 2018, and today, new research discoveries have led to the development of these key interventions:

1. Unless there is obstetric or medical justification, pregnancy should be at least 39 weeks

Although preterm birth is classified as ‘birth before 37 completed weeks of gestation’, one third of brain growth occurs between 35- and 39-weeks’ gestation.

“Babies born in the 37- and early 38-week age groups are at increased risk of behavioural and learning problems at school age,” Chair, Australian Preterm Birth Prevention Alliance Professor John Newnham AM said.

2. Measurement of the length of the cervix at all mid-pregnancy scans

This is one of the best predictors for preterm birth. The measurement is easily done as part of your mid-pregnancy ultrasound scan.

3. Use of natural vaginal progesterone (200mg each evening) if the length of cervix is less than 25mm

“Vaginal progesterone is a small tablet of the natural hormone progesterone, inserted into the vagina each evening at bedtime until 36 weeks of pregnancy,” Chief Sonographer at King Edward Memorial Hospital Michelle Pedretti said.

“Regular ultrasounds to review the cervical length in women who have been identified with a short cervix are sometimes performed to monitor the cervical length up to 24 weeks.”

4. If the length of the cervix continues to shorten despite progesterone treatment, consider surgical cerclage

This is a procedure done during pregnancy in which your doctor will sew your cervix closed.

5. Use of vaginal progesterone if you have a prior history of spontaneous preterm birth

Natural vaginal progesterone tablets to be prescribed for all cases in which there is a history of spontaneous preterm birth between 20- and 34-weeks’ gestation and to be used each night from 16 to 36 weeks’ gestation.

6. Women who smoke should be identified and offered Quitline support

If necessary, adopt a healthy lifestyle before planning a pregnancy.

“It all starts in the home environment well before families decide to embark on the exciting journey of pregnancy,” Co-Lead, QLD Australian Preterm Birth Prevention Alliance Dr Christoph Lehner said.

“An active lifestyle, a healthy diet and smoking cessation all help prevent early birth.”

7. To access continuity of care from a known midwife during pregnancy where possible

High-quality evidence suggests that preterm birth is reduced by around 24 per cent if you are receiving care from a midwife known to you. This is now referred to as a midwifery continuity of care model.

8. Supplementing with omega-3 fatty acids in women with an inadequate dietary intake

The research shows that omega-3 supplementation can prevent preterm birth, but only for women who are low in omega-3 at the start of their pregnancy.

The work of the Whole Nine Months, WIRF and the Australian Preterm Birth Prevention Alliance is focussed on ensuring the next generation of Australians are given the best possible start to life. Visit the website for more.