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Moms' Health Prior to Pregnancy Affects Risk of Preterm Delivery

When it comes to your baby's risk of premature birth, your health before pregnancy may play as important a role as your health during pregnancy, say researchers from Harvard Medical School in Boston, Massachusetts, University of California in San Francisco, and Kaiser Permanente Medical Care Program in Oakland, California.

A group of 1,619 pregnant women who lived in San Francisco completed four telephone surveys - three during pregnancy and one that took place 2 to 3 months after giving birth. During the first interview, the women reported whether they had any chronic health conditions before pregnancy such as anemia, asthma, chronic lung disease, diabetes, hypertension, or cancer. They also were questioned about their general health before becoming pregnant and answered questions about whether they exercised or used tobacco prior to conception. During the subsequent phone interviews, each woman reported how she was feeling physically, emotionally, and mentally. After birth, researchers reviewed each woman's medical record noting the length of the pregnancy, the baby's birth weight, the number of prenatal visits, the use of tobacco, alcohol, or drugs, and chronic or pregnancy-related health problems.

In general, 8% of the women interviewed had preterm births that occurred before 37 weeks of gestation, and African-American women were more likely to have a preterm pregnancy than white women. Researchers also pinpointed several specific prepregnancy risk factors that increased a woman's risk of having a premature delivery:

  • being underweight before becoming pregnant
  • having chronic hypertension before pregnancy
  • having physical function problems before pregnancy
  • smoking before pregnancy

Overall, sociological and demographic factors (like marital status, education level, and household income) contributed 13% to a woman's risk of preterm delivery. In contrast, risk factors that occurred before pregnancy contributed almost 40% to a woman's risk of preterm labor, and risk factors that occurred during pregnancy contributed 47%.

What This Means to You: According to the results of this study, a woman's health before becoming pregnant is almost as important as her health during pregnancy when it comes to the risk of preterm birth. Before you become pregnant, pay a visit to your doctor or obstetrician and discuss any chronic health conditions, physical functioning problems, or harmful health habits. He or she can help you manage and treat problems and suggest ways to improve your health (such as quitting smoking or using alcohol) before you become pregnant so you have the best chance of full-term delivery. If you're already pregnant, be sure to get early and regular prenatal care for the benefit of your baby's health.

Source: Jennifer S. Haas, MD, MSPH; Elena Fuentes-Afflick, MD, MPH; Anita L. Stewart, PhD; Rebecca A. Jackson, MD; Mitzi L. Dean, MHA, MS; Phillis Brawarsky, MPH; Gabriel J. Escobar, MD; Archives of Pediatrics and Adolescent Medicine, January 2005

Reviewed by: Steven Dowshen, MD
Date reviewed: February 2005