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Discusses Women's Health

When a woman delivers at “early term” i.e. between 37 and 38 weeks, most of the time she and her physician are not overly concerned. The baby usually does well and is discharged to go home with the Mom. A new article in the American Journal of Obstetrics and Gynecology may diminish this lack of concern, at least with regards to the Mom’s future health.

The study was carried out by researchers at Harvard Medical School, The University of Bergen in Norway as well as the NIH. (I’ll spare you all the exact titles.) They linked the Norwegian birth records from 1967 to 1968 with mortality of the women between 1967 and 2009. (If you want me to do the math; this was a median follow up of 25 years.) There were 388,662 women in the study. Six percent of first deliveries were preterm at less than 37 weeks.

During the 25 year period after their first birth, the women who had delivered preterm were twice as likely to have died from coronary vascular disease (CVD) than women whose first pregnancy went to full term. Within the preterm deliveries, there was at least a double risk when the delivery was spontaneous and more than a 4 fold risk for medically induced early deliveries. Twelve percent of the women who delivered just a “little” early with the 37 to 38 week gestational period had 41% (if spontaneous) to 60% (if induced) greater risk for future CVD death than those who delivered spontaneously at 39 – 41 weeks.

This was Norway…in 2011 in the United States 10.1% of single baby deliveries were preterm and hence the implications may be greater.

We know that early delivery may often be indicated and induced if the mother has preeclampsia, hypertension, gestational diabetes, obesity or there is fetal growth restriction; all factors that increase the Mom’s future risk of CHD. But this study also suggests that a spontaneous preterm delivery may also merit attention as a CVD risk factor. So when the doctor takes your history and asks you the weight of the babies you delivered in the past, or if there were any complications during the pregnancy (part of a standard history), you should also indicate whether you delivered before 38 weeks gestation. Decades later this may be a warning to pay closer attention to, due to the risk for heart disease.

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