Chances of Repeat PTL/Premature Birth? - Mothering Forums

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#1 of 10 Old 03-09-2009, 07:02 PM - Thread Starter
 
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Just wondering if anyone knows the statistical chances of repeat PTL/premature birth.

I keep thinking of having another but don't know if I can handle a repeat of all that is entailed w/ a birth at 30 weeks (for unknown causes). I had two full term (37 & 38.4 weeks) births previously.

TIA!

- Kim
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#2 of 10 Old 03-09-2009, 11:15 PM
 
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I've googled this subject a ton but can't think of any great links for you. With two full termers I think your chances are excellent of going to term again. I want to say it's something like 12% overall chances of having another preemie, but that includes people (like me!) who KNOW they are going to have another preemie (mis-shaped uterus, which I discovered after my first came at 32 weeks). But it might put your mind at ease to go through a preterm birth evaluation, available at some hospitals (I did it at Robert Wood Johnson in New Jersey). Also in your next pregnancy you will be monitored more closely and while it's more stressful, it's also likelier to catch whatever may have happened before if it's going to happen again.

Good luck!
Sarah
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#3 of 10 Old 03-10-2009, 01:25 AM
 
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I don't know official statistics but my 1st was born at 37 weeks and was my only full term birth. Each baby came a little earlier than the previous one. Maybe since you have had 2 full terms, your preemie was just "bad luck". Really, really bad luck!!!

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#4 of 10 Old 03-10-2009, 03:38 PM
 
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I thought the overall rate of premature birth was around 12%. A previous premature birth does put you at higher risk for a future premature delivery, although I think it depends very much on why you went into premature labor.

I've had friends who had preemie twins go on to have normal single pregnancies. I have had friends with incompetant cervix that lead to ptl in some pregnancies have a cerclage with future pregnancies and then deliver at term.

Like pauletoy, each of my babies were earlier. I think it is primarily a hormonal issue for me. Maybe secondarily a relatively short cervix issue.
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#5 of 10 Old 03-10-2009, 03:39 PM
 
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I am trying to remember - I think the perinatologists told me at the beginning that I had somewhere between a 25-40% chance of delivering prematurely after a previous preterm birth. When my cervix was less thatn 2.5 cm at 20 weeks and I was already having contractions, that went up to like 75%. And when my water broke at 29 weeks, it became 100%...in other words, it also depends how your pregnancy goes what the risk is.
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#6 of 10 Old 03-10-2009, 07:56 PM
 
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GOPLawyer, I am endlessly asking the same question because I have always wanted more than one child. I had my boy at 29w 6d and am extremely scared of having the same or worse experience.

I hate to be the bearer of bad news but today I found a Canadian report called "Too Early too small" and this is what it said about repeat preformances:

"Women who had a previous preterm delivery were more likely to deliver a preterm baby in a subsequent pregnancy. The magnitude of this association depends on the gestational age of the previous preterm birth. For example, the earlier the previous baby was born (that is, the lower the gestational age), the greater the likelihood that the next baby will be born preterm. This association also increases as the number of previous preterm births increases. The increased hazard is observed for both spontaneous and medically indicated preterm births—though the mechanisms underlying the early birth may be slightly different. For example, recurrent spontaneous preterm births have been linked to women who experience ongoing genitourinary infections during pregnancy, while recurrent medically indicated preterm deliveries are usually associated with medical disorders such as diabetes or hypertension. Additionally, maternal ethnicity and cervical length are also associated with recurrent preterm births. Repeated preterm deliveries may also be indicative of poor maternal health, poor nutrition, low SES or other factors."

Here is the link:
http://secure.cihi.ca/cihiweb/produc...o_small_en.pdf
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#7 of 10 Old 03-10-2009, 08:26 PM
 
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This report goes on to say:

"Across Ontario, Manitoba, Saskatchewan, Alberta and the three territories
used in these analyses, the preterm birth rate among women who had
a previous preterm delivery was 22.7%, compared to 6.4% among women
who had previously only delivered at term or post-term. A similar though
less dramatic relationship was observed for SGA rates (8.2% versus 6.7%,
respectively). Provincial/territorial proportions of in-hospital births by previous
preterm delivery status are shown in Appendix B."

I must point out that Canada's rate of preterm birth is 8.1 compared to the USA's of over 12 percent. So I do not know if the recurrent percentage would be exactly the same.
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#8 of 10 Old 03-14-2009, 01:58 AM
 
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I'm with you GOPLawyer!

I had a 27 weeker (he's now 5 yrs) and I'm terrified to try again. We want more children, but I'm not sure I can go through it all again, and maybe not have as great an outcome. We almost lost our son throughout his 5 month NICU stay and I can't imagine the stress of an even more dire situation!

What my OB has told me is that every woman is different, and it depends on the reasons for the preterm labor. For me, my placenta detached from my uterus wall because my uterus wouldn't stretch. ( I had radiation to my uterus due to a bout with cancer at age 18). I guess the best thing would be to talk to your OB about YOUR case specific reasons, they might be able to help you more.
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#9 of 10 Old 03-16-2009, 01:40 AM
 
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Quote:
Originally Posted by GOPLawyer View Post
Just wondering if anyone knows the statistical chances of repeat PTL/premature birth.

I keep thinking of having another but don't know if I can handle a repeat of all that is entailed w/ a birth at 30 weeks (for unknown causes). I had two full term (37 & 38.4 weeks) births previously.

TIA!
I have been told that it depends on the circumstances of your 1st preterm baby. My 1st was a 31 weeker. My water broke at 27 weeks. No known reason. But my doc thinks I will carry the one in my belly to term. Of course we will do all that is possible to help it along as well. There will be a lot more ultrasounds (length of cervix) and I also will start progesterone at 20 weeks. I am also not working at all thru this pregnancy. Well besides taking care of my 19 month old. I am higher risk as well because I had to have a T-Incision to get our little guy out. So now I am at risk of rupturing my uteris if I go into labour. I will not go to full term for that reason. But if we can make it to the scheduled 39 week mark I would be sooooo happy. Although docs are not sure why my water broke I am pretty sure it was because I raced 6 horses in +35c weather, walking thru a foot of sand. So no ponies for me this time around. But a 19 month old baby can be just as wild, ha ha lol.
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#10 of 10 Old 03-16-2009, 06:04 PM
 
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no hard and fast statistics to share with you, but the single biggest predictor of a preterm birth is history of a previous preterm birth. for me, that held true - my first ws 36 wk, then 34 wk, 32 wk and 34 wk. All but the first were preceeded by preterm labor with bedrest, and all were from premature rupture of membranes.
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