Am I at risk of premature birth? Know the risk factors

Posted on 31 January 2020

There are a number of reasons why you might be likely to give birth more than three weeks before your baby’s estimated due date.

As Dr Ntlharhi Mathonsi, a gynaecologist and obstetrician at Mediclinic Midstream, explains, a premature birth is one that occurs before the start of the 37th week of pregnancy. Risk factors include your pregnancy history, health of your cervix, infections and obstructions in your womb. “If your gynaecologist thinks you may give birth early, she will ensure you have more regular antenatal appointments, plus extra tests and checks to ensure the health of you and your baby,” says Dr Mathonsi. “The more premature deliveries you’ve had in the past, the higher the risk of premature delivery with your current pregnancy.”

Dr Mathonsi adds that intrauterine infections can also have serious consequences for your unborn baby. “A viral or bacterial infection can enter the uterus through the vagina, infecting the amniotic sac and fluid,” Dr Mathonsi explains. “Rupture of the sac and premature labour and delivery can follow.” If tests show that you have an infection, your doctor will most likely treat it with antibiotics to ensure your baby’s safety.

Pre-eclampsia is a serious blood pressure disorder that can affect all your organs and is another risk factor for premature birth. The earlier pre-eclampsia – and the more severe eclampsia – is diagnosed and monitored, the better the outlook as these conditions can affect your baby’s growth and can be life-threatening.

You also might suffer from cervical weakness, due to past surgeries or childbirth. As Dr Mathonsi explains, if scans show you have a problem, you might need a cervical stitch or cerclage. This should ideally be done 12 to 14 weeks into your pregnancy. After 24 weeks of pregnancy, a cervical stitch could cause the amniotic sac to rupture and make your baby come too soon.
Living with diabetes might also affect your risk of giving birth prematurely. “Ideally you should have good control of your blood glucose before falling pregnant, to assist a healthy pregnancy,” says Dr Mathonsi. “If you rely on insulin, you might also need to change your dose while you are pregnant. If you develop gestational diabetes, your doctor will give you advice about how to keep your blood sugar stable.”

In addition, if your waters break before your baby has reached full term (37 weeks), it can trigger early labour. The medical term for this is Preterm Prelabour Rupture of the Membranes (PPROM) and it may be caused by smoking, vaginal bleeding, a weak cervix or infection.

Other risk factors for premature birth include bleeding after the first trimester, carrying more than one baby, and obstructions (such as fibroids) in your womb.
“Your doctor will monitor you very closely for any signs that you might be at risk of premature delivery,” says Dr Mathonsi. “In many cases, a combination of medication, interventions and therapies can be used to help you carry your baby to full term.”


If you are concerned about anything pregnancy or birth related, schedule an appointment with one of Mediclinic’s expert gynaecologists and obstetricians.

Mediclinic hospitals, day clinics and staff are ready to welcome you for your regular doctor’s appointments and screenings.


Published in Pregnancy

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.