Baby in nicu

Preventing Premature Birth

Private: Thomas McElrath, MD, PhD
Contributor Thomas McElrath, MD, PhD

There are a number of effective treatment approaches that can help prevent or delay preterm birth depending on a mother’s condition.

“Medications and, in some cases, surgery can be used to minimize risks associated with preterm delivery,” says Thomas Frederick McElrath, MD, PhD, an attending physician in the Division of Maternal-Fetal Medicine at Brigham and Women’s Hospital.

One in nine babies in the United States is born prematurely (before 37 weeks of pregnancy). These babies have a higher risk of short- and long-term complications, and the risk increases the earlier the delivery.

To provide additional support to the cervix and help prevent preterm labor, specialists sometimes use a soft flexible ring (pessary) or a stitch (cerclage) at the cervical opening. Other approaches include the use of progesterone, a hormone, to prolong pregnancy.

In addition to a history of preterm delivery, other risk factors for preterm birth include prior cervical surgery, reproductive tract or uterine anomalies, multiple gestation pregnancy (twins, triplets, or more), low or high maternal age, and high blood pressure.

“Preconception planning and specialized care are key for women at high risk for preterm birth,” says Dr. McElrath. “A multidisciplinary team dedicated to evaluating, treating, and monitoring these patients will be able to ensure the best possible outcomes for babies and their families.”

In July 1987, twin sisters Justine and Alexandra Bryar were born at Brigham and Women’s Hospital at 25 weeks gestation, each weighing only three pounds. For months, their parents visited the newborn intensive care unit (NICU) daily to be with their newborn girls. The Brigham became a home away from home for nearly the first year of their lives. Despite their struggles at birth, Justine and Alex grew into healthy young women. Now, years later, they have both rejoined the Brigham family in new ways — Justine as an assistant director for Brigham Development and Alex as a primary care medical assistant at Brigham and Women’s Faulkner Hospital. Alex dreams of becoming a nurse and working in the NICU someday.

Private: Thomas McElrath, MD, PhD
Thomas McElrath, MD, PhD

Thomas McElrath, MD, PhD, is an attending physician in the Division of Maternal-Fetal Medicine at Brigham and Women’s Hospital.

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