Preterm birth remains a cause for a significant number of infant deaths world wide and to cause a large number of long-term complications. The disorders, for which premature children are at an increased risk include, but are not limited to cerebral palsy, sight and hearing problems, as well as developmental delays. It is also considered, that the earlier the child is born, the higher all these risks are. In a large number of cases the exact reason for the preterm birth is not known. (WHO, 2014). In order to discuss the problem in more details, it is first of all necessary to precisely define the term.
A preterm birth or a premature birth is a birth of an alive infant at an age of less than 37 weeks of gestation. The estimation of WHO (2016) is that annually over fifteen million infants are born premature. This number is constantly growing. However, in order to clearly understand the picture, it is important to remember, that on the one hand the overall population of the Earth is growing, while on the other hand by far not all premature births are documented. Another important figure to consider is that the complications, associated with premature birth cause the majority of health problems in the children before five years of age. WHO reports that in 2015 such complications caused as many as one million deaths of children? In the United States the percentage of premature births was approximately at the level of 10% in 2015 (CDC, 2016). CDC statistics also show that the percentage of premature birth in the United States was falling between 2007 and 2014, which is assumably assigned to the fall of births by teenagers and young mothers. However, in 2014 a new rise began, however the reasons for such are not clear as for now (CDC, 2016). According to WHO information, the rate of premature births varies between 5% and 18 % across the world.
Among other factors, which are known to contribute into premature birth ratio there is a group of factors which are oftentimes overlooked and underestimated. This happens because they are not medical or physiological factors; however, being left unattended these factors May, in the final score, lead to physiological issues andconditions, which, in their turn, may lead to preterm births. These factors are known as psychosocial factors. As it is obvious from the name, these factors have to do with social environment of the mother and her psychological state.
Unfortunately, the influence psychosocial factors have got upon premature birth ratio is not clearly understood. There are some researches, like the one described by Savitz et al (2003), which shows, that women for whom psychosocial factors have been identified had 12% preterm birth ratio, however, serious research on the state or international level have not yet been completed. This is even more complicated due to the fact that psychosocial factors are uneasy to identify in women. Among other factors it has been identified that Stress/depression/anxiety/previous traumatic experience increase likelihood of preterm birth in women. However, the ratio is different for different ethnicities and races. Which may be partially assigned to physiological differences, while partially also to discriminatory practices which more or less exist in every society. Marital status is known to be another important factor to influence the ratio. Unmarried women are known to have a tendency to deliver premature babies. This may, however, also be associated with their financial state and, consequently, the conditions they live in. Educational inequities are known to also influence the ratio, since women who have no access to reasonable educational services are not aware of the importance of health care measures to be taken to decrease the risk of premature delivery. Physical violence may increase chances of premature delivery by means of increasing stress level, or directly provoke it as a result of physiological changes, which derive from the violent act. Social inequities are also associated with increased stress level and thus may result in premature delivery as well. Unfavorable neighborhood may also influence the ratio, since such may be associated with increased infectious risks, increased stress level, violence and other factors, which may influence the chances of preterm delivery.
All these factors are known to influence the likelihood of premature delivery, but it is very difficult to establish precise ratios, though attempts have already been made. At the same time it is important to understand the mechanisms of these factors influencing premature births. This understanding will allow making attempts to decrease the number of premature deliveries by means of preventing them. This is why there is a significant need for further exploration of the issue and new thorough research in the field. It is important not only to establish the degree, to which one or another category of psychosocial factors are related to percentage of premature births, but also to what degree this influence is direct or, on the contrary, mediate, and how these factors correlate with the racial and ethnicity factors (both cultural and physiological). In order to decrease the percentage of premature births, caused directly or mediately by psychosocial factors, or at least in order to undertake such an attempt, it is important to depend on solid data, clearly established interdependencies. One of the methods of combating high percentage of premature births due to psychosocial factors, it is first of all important to educate future mothers as for the significance of the influence these factors have got on timely delivery and consequent state of health of their infants.
- CDC. “Preterm Birth”. Maternal and Infant Health. Available online at https://www.cdc.gov
- Savitz, D., Hertz-Picciotto, I., Siega-Riz, A., McMahon, M., & P. Buekens. (2003). Maternal Stress and Preterm Birth. American Journal of Epidemiology, 157 (1): 14-24. Available online at https://academic.oup.com
- World Health Organization (November 2016). “Preterm birth. World Health Organization. Available online at http://www.who.int