Premature birth definition, causes & warning signs

What is considered a preterm birth? At what point is a preterm birth not a cause for concern? What can trigger it? What is the purpose of an incubator for babies born too early? What does a premature birth mean for maternity leave? Find out more.

Premature birth: definition

When is a birth no longer preterm? A preterm birth is defined as birth before the end of the 37th week. Births beyond the 37th week (37+0) are no longer classed as preterm by medical professionals. In Switzerland, 7% of all newborns arrive early. Specialists differentiate between three types of preterm birth depending on the stage of pregnancy:

Extreme prematurity: birth before the 28th week of pregnancy
Early prematurity: birth from the 28th up to the 32nd week of pregnancy
Late prematurity: birth from the 32nd up to the 37th week of pregnancy

Preterm babies often weigh between 500 and 2,500 grams, but some babies’ weight is classed as premature even if they are born around their calculated due date. So due date alone is often not the sole factor in determining whether a newborn is premature.

Premature birth: at what stage is it not a cause for concern?

At what point can a baby survive premature birth? The chances of survival following premature birth depend on the actual delivery date: premature babies born before the 22nd week of pregnancy have minimal chances of survival. In the case of premature birth beyond the 24th week of pregnancy, the chances of survival are around 60%. If the baby is born after the 28th week of pregnancy, despite premature birth, the chances are around 90%. So at what point are babies viable? The 23rd week of pregnancy serves as a point of reference. At this stage, babies are generally deemed viable.

Premature birth: causes and risk factors

There are various triggers and risk factors for premature birth. These include:

Heat: researchers suspect that there may be a link between climatic conditions and premature birth. It has been suggested that heat increases the risk of a preterm birth. One or two hot days are regarded as bearable, but three days of sustained heat is associated with an increased risk of preterm birth. Temperatures of 30 degrees Celsius and upwards increase the likelihood of a premature birth by 20%. At 35 degrees Celsius, the risk is as much as 45%.
Smoking: the risk of premature birth due to smoking is 39% – this is on top of a high likelihood of stillbirth and birth defects.
Stress: another potential cause of premature birth is mental stress.
Infections: infections during pregnancy may sometimes lead to premature birth, too. This relates primarily to infections of the birth canal, such as a vaginal infection.
Progesterone deficiency: studies suspect that the hormone progesterone inhibits uterine contractions, stabilises the cervix and thus reduces the risk of premature birth. In certain cases, the daily administration of progesterone during pregnancy therefore helps to lower this risk.
Age: the age of the expectant mother is another factor. Women below the age of 18 and above the age of 35 are more likely to experience premature birth.
Certain disorders: pregnancy-related high blood pressure and gestational diabetes also increase the risk of preterm birth. Benign tumours, cervical insufficiency and placental insufficiency also result in premature delivery in some cases.
Genetic factors: under certain circumstances, premature birth may be related to genetics. If the pregnant woman’s mother gave birth prematurely, the probability of premature birth in the first pregnancy increases by 60%.¨
Causes related to the child: occasionally, multiple pregnancies, birth defects or gene changes in the child may lead to premature birth.

By the way, there are also medically justified and medically necessary premature births, e.g. if the baby is no longer getting what it needs in the womb, or other pregnancy complications put the child or the mother at risk. This is referred to as iatrogenic premature birth. This is particularly common in multiples: about one in three multiple births before the 37th week of pregnancy are medically justified.

Premature birth: how can the health insurance company help?

Where medical measures are necessary to prevent a premature birth, we cover the costs of hospital stays under basic insurance. And we continue to support you after childbirth, too: our basic insurance covers assistance from a midwife in the first eight weeks postpartum. We also cover the costs of three breastfeeding guidance sessions conducted by a specialist. And our HOSPITAL insurance even offers additional support in the form of postpartum household help.

Deductibles, excesses and hospital cost contributions for the benefits specified are waived during the first eight weeks. In fact, this applies beyond this period for breastfeeding guidance sessions.

View all insurance benefits

Signs of a premature birth

In most cases, premature birth is accompanied by certain warning signs:

Early, regular contractions lasting more than 60 minutes
Premature rupture of membranes with gushing or dripping outflow of amniotic fluid• Vaginal bleeding
Discoloured and malodorous discharge signalling infection
Cramps similar to menstruation

Premature birth: is there a risk of recurrence?

Pregnant again after a pre-term birth? If so, you are at increased risk of having another premature birth. If you gave birth before the 37th week of pregnancy, the risk is 20%. If delivery was before the 32nd week of pregnancy, there is a 30% chance. The risk of recurrence increases further with every premature birth.

Premature birth: consequences

Premature birth may involve major or minor complications. Whether or not these have consequences for the child is dependent, among other things, on their birth date and birth weight. Specialist consultants assess the complications on a case-by-case basis and make an appropriate diagnosis.

A premature birth often leads to a developmental difference between premature babies and children of the same age who are carried to term. This difference generally evens out by the age of eight.

Treatment for premature birth

If you suspect you are at risk of experiencing a premature birth, contact your doctor as soon as possible. It may be possible to delay the birth – for example, with contraction-inhibiting medication and bed rest. If this is not possible or necessary, medical professionals will allow or induce the birth. Premature babies receive treatment immediately on delivery:

The incubator plays an important role after a premature birth, ensuring optimum oxygen uptake for premature babies. It also regulates ambient temperature and humidity and protects the immune system of the premature baby. In addition, doctors monitor the breathing and cardiovascular function of the newborn intensively.
Ideally, premature babies will receive breast milk from the off. This provides nutrients that are important for growth and development.
Regular physical contact with the premature baby, the skin-to-skin method, is another part of treatment. The baby lies on the naked upper body of the mother or father for several hours a day. This promotes the emotional bond and strengthens the health of the newborn: they exhibit less stress, breathe more stably, sleep better and develop faster than premature babies that don’t experience extensive skin contact.
In some cases, premature babies experience complications that may require surgery. Whether or which intervention is necessary is assessed by specialists on a case-by-case basis

Premature birth and maternity pay

Your 14 weeks of maternity leave normally start immediately after the birth of your child. However, premature babies usually remain in hospital for monitoring. If this is the case, you have the option of extending your maternity leave by the duration of the hospital stay (up to a maximum of 56 days). This is associated with an extension of maternity cover (in the sense of protection against dismissal) after a premature birth. The prerequisite for this is that your premature baby remains in hospital for at least fourteen days, and you plan to return to work after maternity leave.

Important: expectant mothers usually apply to extend their maternity leave when they register for maternity pay. During maternity leave, you receive 80% of your salary, but no more than CHF 220 per day. In order for the competent authorities to approve the application, you will need a medical certificate.

There is no extended joint parental leave for mothers and fathers in cases of premature birth. Swiss federal law does not generally provide for parental leave. However, there are some companies and industries that grant parental leave to those affected. The duration and amount of compensation vary.

Avoiding premature birth

It’s not always possible to prevent premature birth. However, it may be possible to reduce the likelihood of premature birth:

Cut out alcohol and cigarettes entirely during pregnancy. These compromise the nourishment your child gets.
Pay attention to your diet. It is particularly important to get nutrition right during pregnancy. This should ideally be high in nutrients like folic acid, iron and iodine.
Attend all your medical checkups. This will enable your doctor to identify any potential complications ahead of time. For example, an individual growth chart can help them to identify when the foetus is too small or too light.
Make sure you are following a healthy lifestyle. This will support your baby’s growth.
Take it easy during pregnancy. Avoid physical and mental stress. Ask relatives for help if need be and integrate relaxation methods like meditation into your everyday routine.

The well-being of your baby is important to you. By taking the right precautions and adopting a mindful lifestyle, you can create the ideal conditions for a pleasant pregnancy and reduce the risk of premature birth. Often, even small changes in everyday life can make a big difference. If you are unsure, it is best to talk to your doctor.