Later in the article, we will detail what is known about recurrent preterm birth and what can be done to reduce the chances of recurrence.

Premature birth results from a combination of factors. We know how to point out some of the risk factors, but even if you carry some of them, you won't necessarily give birth early.

On the other hand, sometimes premature labor begins on its own and without any warning, and unfortunately, even if you did everything necessary throughout your pregnancy, you may still give birth prematurely.

The main risk factors currently known for the development of recurrent preterm birth are:

• Previous preterm birth – Women who have previously given birth prematurely have a 251% to 351% chance of giving birth prematurely in their next pregnancy.
• Twin or multiple pregnancy – 50%-60% chance of preterm birth
• A uterus with an abnormal structure, such as a unicornuate or bicornuate uterus
• A cervix that has undergone surgical intervention such as conization

Additional risk factors during pregnancy that are mentioned in the professional literature and that have been found to be associated with recurrent preterm birth:

• Underweight or overweight before pregnancy
• Eating disorders such as anorexia or bulimia.
• Getting pregnant shortly after the previous birth. An interval of at least 18 months from the previous birth is recommended.
• Age under 17 or over 35.
• Pregnancy through in vitro fertilization (IVF) treatments
• History of preeclampsia
• High blood pressure
• Infectious diseases transmitted through sexual contact
• Smoking
• Exposure to air pollution and passive smoking
• Non-medical drug use and prescription drug use
• Stress in everyday life.
• Low socioeconomic status
• Domestic violence
• A lot of standing on your feet

Medical risk factors that appear during pregnancy that may lead to the development of preterm labor:

• A cervix diagnosed as short in the second or third trimester of pregnancy
• Vaginal bleeding in the second or third trimester of pregnancy
• Urinary tract and vaginal infection.
• Early water drop.

If there is a risk of premature birth, your doctor may recommend one or more of the following measures:

• Follow-up ultrasound examination along the cervix from week 16. A cervix shorter than 25 mm is a warning sign
• Fetal fibronectin (fFN) test from the vagina or cervix
• Progesterone hormone therapy as daily vaginal tablets or weekly injections.
• Cervical suture – cerclage
• Using a pessary – a silicone device inserted into the vagina around the cervix
• Contraction-suppressing medications called tocolytics are designed to delay labor by at least 48 hours.
• At the same time, treatment with steroids accelerates the maturation of the fetus's lungs and reduces the chance of cerebral hemorrhages in the fetus.

Due to the higher risk of recurrence among women who have had a premature birth, the recommendation is to plan the next pregnancy:

• Use birth control until you are ready to get pregnant again.
• Keep an 18-month gap between your last birth and your next pregnancy.
• Arrive in optimal health with balanced chronic diseases such as hypertension, diabetes, and thyroid function.
• Conduct regular pregnancy monitoring in order to detect as early as possible risk factors that can be treated, such as: cervical shortening, inflammation and vaginal infections.
• Avoid smoking.
• Avoid drinking alcohol and using non-medical drugs.
• Find the right balance between work and home and reduce stressors.
• Seek help if your partner is violent towards you.
• Get enough rest. Pregnant women should sleep 8 hours a night.
• Avoid intensive work, carrying heavy objects, or activities that require a lot of effort.

By Dr. David Shesher, gynecologist and CEO of Fertility Tech

Fergnantech Home – PregnanTech is developing an innovative device to delay premature birth. The device, called Lions, is currently in a clinical trial among pregnant women at risk of premature birth and is taking place at the Hadassah Jerusalem, Sheba Tel Hashomer, Kaplan Rehovot and Meir Kfar Saba medical centers. For details and registration:  https://bit.ly/3otz9hn