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Risk Detail: Pregnancy History

Pregnancy history and specific pregnancy-related factors have consistently been found to be associated with an increased risk for preterm birth and related complications. 

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These factors specifically include:

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You can read more about these factors below.

 

There are many additional risk factors not outlined here. More information about preterm birth and risk factors can be found on the websites of the CDC and the US National Institute of Health.

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First Time Pregnancy

Nulliparity (no previous live birth)

Kissng the Newborn

Nulliparity, defined as not having a previous live birth, has consistently been shown to be associated with an increased risk for preterm birth.

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While the reason for this increased risk is not fully understood, there is some data to suggest that when a person has had a live birth before, the body is already used to changes associated with pregnancy making it easier for them to support the baby.

 

There is also some data to suggest that those who have had a previous live birth are more likely to attend regular prenatal check-ups, which can identify potential problems early on and reduce the risk of preterm birth.

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Aspirin therapy has been recommended for use in nulliparous pregnant women and expectant mothers who have one or more of these other risk factors present as well: 

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  • Obesity (ie, body mass index >30)

  • Family history of preeclampsia (ie, mother or sister)

  • Black persons (due to social, rather than biological, factors)

  • Lower income

  • Age 35 years or older

  • Personal history factors (eg, low birth weight or small for gestational age, previous adverse pregnancy outcome)

  • >10-year pregnancy interval

  • In vitro conception

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You can read more about aspirin therapy on our website.

 

It is important that all pregnant women and expectant mothers - and especially those at increased risk, be aware of early signs of premature labor

 

It is important that all people who are pregnant have a prenatal care provider who can help them monitor their pregnancy health. Links to help and resources can be found HERE.

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Related links - 

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Previous preterm birth

Previous Preterm Birth

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Having a previous preterm birth is a significant risk factor for preterm birth in a current pregnancy. Studies have shown that people who have had a previous preterm birth are at a higher risk of delivering prematurely in subsequent pregnancies. The risk is even higher if the previous preterm birth occurred before 34 weeks of gestation.

 

In addition to the increased risk of preterm birth, individuals with a history of preterm birth may also be at higher risk for other pregnancy complications such as gestational diabetes, preeclampsia, and placental abruption.

 

Individuals with a history of preterm birth should be working closely with their healthcare provider to closely monitor their pregnancy. 

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Low-dose aspirin use may be an especially effective intervention for preventing preterm birth and preeclampsia in those with a previous preterm birth who have other risk factors present (see overview of factors associated with increased risk here). It is important to be working with a prenatal provider to determine if the use of low-dose aspirin may be helpful to you.

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It is important that all pregnant women and expectant mothers - and especially those at increased risk, be aware of early signs of premature labor

 

It is important that all people who are pregnant have a prenatal care provider who can help them monitor their pregnancy health. Links to help and resources can be found HERE.

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Related links - 

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Previous C-Section

Previous Cesarean Section

Brother's Hug

Having a previous cesarean section (c-section) can increase the risk of preterm birth and other pregnancy complications in a current pregnancy.

 

Studies have shown that individuals who have had a previous c-section may be at a higher risk for preterm birth, placental problems, and uterine rupture. The risk of preterm birth is higher if the previous c-section was performed before 34 weeks of gestation.

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To address the increased risk of preterm birth and other pregnancy complications in women with a previous c-section, it is important to be seeing a prenatal provider regularly so they can closely monitor the pregnancy. Those with a previous c-section may require additional monitoring and interventions, such as ultrasound and fetal monitoring, to reduce their risk of preterm birth.

 

Vaginal birth after cesarean (VBAC) may also be an option for some women, as it has been shown to be a safe and effective alternative to repeat c-sections for certain patients. However, not all women are candidates for VBAC, and the decision should be made in consultation with a healthcare provider.

 

Improving access to prenatal care, addressing social determinants of health, and reducing disparities in healthcare are also important in reducing the risk of preterm birth and other pregnancy complications in those with a previous c-section.

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It is important that all pregnant women and expectant mothers - and especially those at increased risk, be aware of early signs of premature labor

 

It is important that all people who are pregnant have a prenatal care provider who can help them monitor their pregnancy health. Links to help and resources can be found HERE.

​

Related links - 

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C Section

Short or Long Time Since Last Pregnancy (less than 18-months or 5 or more years)

Mother Daughter Portrait

When a person becomes pregnant again soon after a previous pregnancy (less than 18 months) or after a long time (5 or more years), they may be at risk for preterm birth. It's not clear why this happens, but it may be because the body hasn't had enough time to recover or because the uterus isn't functioning well.

 

It's important to talk to your prenatal provider about how your own pregnancy may be affected by the time between your pregnancies. Other risk factors, like your age and health, can also affect your overall risk.

 

If you have a long interval (10 or more years) between pregnancies, low-dose aspirin may help reduce your risk of preeclampsia and preterm birth. You can read about the use of low-dose aspirin here.

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If you have a short or long interpregnancy interval and this is associated with an increased risk of preterm birth in your race/ethnicity by insurance grouping (based on HPQ models of more than 5 million California births), then this factor will be included in your overall HPQ score. This and other factors affecting your preterm birth risk should be discussed with your prenatal provider. 

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If you are completing a HELLO EGG Healthy Pregnancy Plan and have either a short or long interpregnancy interval, it will be important to note how you plan to manage and address this risk with your provider.

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Related links - 

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Short or long IPI

Read More

OTHER SPECIFIC FIRST TRIMESTER RISK FACTORS FOR PRETERM BIRTH

 

Social and Demographic Factors​​

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Health and Diagnoses Present Before Pregnancy - 

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Weight, Diabetes, and Hypertension

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Other Conditions 

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Exposures

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ADDITIONAL SECOND AND THIRD TRIMESTER RISKS FOR PRETERM BIRTH 

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Conditions 

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Wellness and Care

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