Early this May, the first-ever national, regional, and global estimates of preterm birth were reported. It turns out that 15 million babies are born too soon, and over 7% of these babies die shortly after birth. (1)
In order to combat the rise of preterm births in the United States, routine prenatal care checks for vaginal infection and for the presence of other inflammatory markers.
Inflammatory markers are biochemical signs of trouble. They can signal infection or the body struggling to respond to disease.
Both inflammatory markers and vaginal infection are established risk factors for preterm birth. Unfortunately, it turns out that the golden standard for a healthy birth canal may not be as clear-cut as previously thought.
At 37 weeks, a fetus is considered full term. If birth occurs any time before 37 weeks, this is what is known as a preterm birth.
12 percent of babies born in the US are premature, leaving them at risk for brain injury, respiratory disorders, chronic infection, and even cerebral palsy.
Preterm births are a health concern because those born prematurely usually face a lifetime of compromised health. (2) This could mean:
- Chronic infection
- Cerebral palsy
- Brain injury
- Respiratory disorders
- Hearing difficulties
- Learning and developmental disorders
About 12 percent of the babies born in the United States, or more than 1 in 9 births, are preterm.
While the United States preterm birth rate has declined over the last several years, this number is still too high. Many researchers and health care professionals are searching for reasons as to why so many babies are born too soon.
Dr. Craig Rubens, contributor to the most recent report on preterm births, says that this news “sounds the alarm that prematurity is an enormous global health problem that urgently demands more research and resources.”
Many studies have been done to confirm that vaginal infection, urinary tract infection, and infection within the uterus are associated with a higher risk of preterm birth. (3)(4)(5)
If you have children or are pregnant, you may be familiar with the Group B Streptococcus (GBS) test. It is a part of routine prenatal care.
This is because vaginal or urinary infection with Group B Streptococcus (GBS) is documented as the most frequent infectious cause of infant death in North America and Europe.
GBS is fairly common in women and in expectant mothers. Up to 30% of mothers have an asymptomatic infection of GBS. Because the infection is asymptomatic, most women do not know that they are carriers of the bacteria.
Because of this, preventative care involves screening for the GBS microbe. If found, both the mother and the newborn are placed on antibiotic therapy.
The use of antibiotic therapy during labor and after delivery affects the ecology of mother and child. Antibiotic therapy can be lifesaving. However, scientists are exploring other options because it also:
- Increases the risk of infection from other microbes besides GBS. (6) An infection from these bacteria is just as dangerous as a GBS infection.
- Encourages antibiotic resistance. Widespread use of certain antibiotics has actually been shown to contribute to the increase of GBS infection. (7)
The role of infection does not end with the birth canal or the uterus. In fact, a study done in 2009 found that preterm delivery occurred in nearly 65 percent of patients with both gum disease and a bacterial infection in the birth canal. (8)
This tells us that:
- Infection can becomes systemic, or in other words, affect the whole body.
- The immune system is sometimes too overwhelmed to fully protect the body.
20 years ago we believed that lactobacillus bacteria, which produce lactic acid, were the hallmarks of a healthy inner ecosystem.
We now know that a woman’s birth canal has many different terrains. Lactobacillus makes up a whole group of bacteria that are notoriously helpful to our immune system and to our overall wellbeing.
Studies have even found that lactobacillus bacteria protect against preterm birth. (9)
However, if lactobacillus bacteria are not the most robust members of a woman’s inner ecosystem, this does not necessarily mean that she is more open to infection or disease. (10)
Studies show that:
- At least 5 different types of bacterial communities can colonize the birth canal.
- 3 of these 5 types are dominated by Lactobacillus.
- The other 2 types are a diverse group of various microorganisms, with few members from the Lactobacillus group.
This means that changes in a woman’s vaginal flora are not necessarily a sign of disease. In fact, most women experience fluctuations based on:
- Estrogen levels
- Sexual activity
- Menstrual cycle
Nonetheless, many women without any symptoms are diagnosed as having bacterial vaginosis, or a bacterial infection of the vaginal canal, and placed on antibiotics.
Unfortunately, both are all too common.
Dr. Craig Rubens explains that, "Even if every known intervention was implemented around the world, we would still see 13.8 million preterm births each year; we could only prevent 8 percent."
Preventative care needs to go beyond Group B Streptococcus (GBS) screening and antibiotic therapy.
Worldwide, we are seeing more and more people consume sugar-rich, processed foods while forgetting about the value of traditional ferments. The immune system suffers. The microbial communities that we house are shifting from beneficial to pathogenic, or disease-causing.
With antibiotic resistance on the rise, antibiotic therapy is less of an answer and more of a band-aid. For this reason, many healthcare professionals now exercise some degree of caution before prescribing antibiotics.
4 Steps of Healing
Restoring balance to the inner ecosystem, whether in the gastrointestinal tract or in the birth canal, is based upon 4 Steps of Healing:
2. Correct Digestion: By nourishing the body’s natural digestive power, we strengthen all systems of the body.
3. Conquer Infection: Many of us are obsessed with being germ-free. We have forgotten about the benefits of a hardy inner ecosystem. Instead of waging war on the microbial residents that we live with (and hardly understand), choose foods and a lifestyle that starve disease-causing microorganisms and that support a balanced inner ecosystem. Again, an emphasis on fermented foods and probiotic beverages is crucial.
4. Cleanse Toxins: Our bodies are exposed to toxins on a daily basis. When we decide to gently cleanse the body of toxins, we become less hospitable to disease, and we open up to wellness.
What to Remember Most About This Article:
15 million babies are born prematurely each year, making it the second leading cause of death in children under the age of five. Established risk factors for preterm birth include inflammatory markers and vaginal infection.
Since infection is one of the strongest risk factors for preterm birth, many women may be placed on antibiotic therapy during labor to fight common infection caused by Group B Streptococcus. Unfortunately, antibiotic therapy can leave both mother and baby at risk for other infections and even antibiotic resistance.
Before considering antibiotics, it's time to get your inner ecosystem back on track, during pregnancy and for the future.
Here are 4 Steps of Healing you can use today to bring your inner ecology back into balance:
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- Honein, et al. The Association Between Major Birth Defects and Preterm Birth. Maternal and Child Health Journal. doi: 10.1007/s10995-008-0348-y
- March of Dimes Foundation. US preterm birth rate under 12 percent, the lowest level in nearly a decade. ScienceDaily. Nov 2011.
- R Romero, et al. Micronutrients and intrauterine infection, preterm birth and the fetal inflammatory response syndrome. J Nutr. 2003 May;133(5 Suppl 2):1668S-1673S.
- MW Kemp, et al. Preterm birth, infection, and inflammation advances from the study of animal models. Reprod Sci. 2010 Jul;17(7):619-28.
- A Ovalle, et al. Risk factors for preterm deliveries in a public hospital. Rev Med Chil. 2012 Jan;140(1):19-29. Epub 2012 Apr 12.
- RS Baltimore, et al. Early-onset neonatal sepsis in the era of group B streptococcal prevention. Pediatrics. 2001 Nov;108(5):1094-8.
- CV Towers, et al. Potential consequences of widespread antepartal use of ampicillin. Am J Obstet Gynecol. 1998 Oct;179(4):879-83.
- A Ovalle, et al. Relationship between periodontal diseases and ascending bacterial infection with preterm delivery. Rev Med Chil. 2009 Apr;137(4):504-14. Epub 2009 Jun 25.
- MA Krohn, et al. Vaginal Bacteroides species are associated with an increased rate of preterm delivery among women in preterm labor. J Infect Dis 1991;164:88-93.
- J Ravel, et al. Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci U S A. 2011 Mar 15;108 Suppl 1:4680-7. Epub 2010 Jun 3.
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