Preterm Labour

Risk factors:

– Previous preterm abnormality

– Bacterial vaginosis

– UTI/ STI

– Gestational diabetes

– Hypertensive disorders of pregnancy

– Cervical incompetence (previous cone biopsy)

– Intrauterine infection

– Multiple pregnancy

– Use of ART

– Uterine abnormalities

– Polyhydramnios/ oligohydramnios

– Placental abruption/ previa

– Interpregnancy duration of < 6 months

– Smoking

Preterm Births

Preterm (premature) infants are those born at <37 weeks gestation. 

Extremely preterm infants are born at <28 weeks gestation 

Example

• If Baby born at 32 weeks’ gestation
• Baby is 8 weeks (2 months) preterm
• If current 4 months old (16 weeks since birth), her corrected age is 2 months
• even if baby is 4 months old, should expect developmental skills of a 2-month-old term baby. 

Vaccinations

• All preterm infants born at <28 weeks gestation are recommended to receive 4 doses of 13vPCV
• hepatitis B
  • Low-birthweight infants (<2000 g) and/or infants born at <32 weeks gestation (irrespective of weight) are recommended to receive:
    • hepatitis B vaccine at birth
    • 3 doses of a hepatitis B–containing vaccine, at 2, 4 and 6 months of age
    • a booster dose at 12 months of age
• Influenza vaccine
  • Preterm infants should receive influenza vaccine every year, starting at ≥6 months of age. 
  • Infants should receive 2 vaccine doses, at least 4 weeks apart, the 1st time they receive influenza vaccine, then 1 dose every year after that (see Influenza).
• Rotavirus vaccine
  • Preterm infants can receive rotavirus vaccine at their chronological age without correction for prematurity. This includes hospitalised infants who are medically stable.
• Hib vaccine
  • Preterm infants do not need a change to the usual schedule for Haemophilus influenzae type b (Hib) vaccines conjugated with tetanus (PRP-T), 
  • administration at 2, 4 and 6 months of age. 
• hepatitis B and Hib
•  are not quite as high as in full-term infants.