Elizabeth Arnold’s due date wasn’t until close to Mother’s Day, but seven weeks before she was expected to give birth to her first daughter, the unexpected happened.

First, her water bag broke. Then when the physicians tried to induce labor, Arnold began to hemorrhage. To prevent further complications for the mother and her baby girl, Ella Rose, they had to do an emergency caesarean section.

Ella Rose weighed a little more than four pounds, but in spite of her small size, she was healthy. Even so, her mother didn’t want to take any chances when she became pregnant with her second child.

A Bigger Gift

The Houston resident was one of almost 500 women who enrolled in a National Institutes of Health study to test whether weekly injections of 17 alpha-hydroxyprogesterone, or 17P, a progesterone-derived hormone, prevented preterm births.

The results were so compelling that the clinical trial was halted so that all women—not just those in the study—who have a high risk of premature labor, would have the opportunity to receive the hormone therapy.

Of those who received the progesterone treatment, the risk of preterm birth before the 37th week of pregnancy was reduced by 34 percent. The preterm birth risk prior to 32 weeks was reduced by 42 percent.

“I’m a believer,” Arnold said. “Ruby was due on Jan. 12, and she came on Jan. 2. She is perfect.”

Risk of Prematurity

Dr. Susan Ramin, who led the research at The University of Texas Medical School at Houston, said mothers-to-be have an 11 percent chance of delivering a premature baby. And women who have already had a premature baby are at even greater risk – by as much as 50 percent -- of going in to preterm labor during subsequent pregnancies.

Every day, more than 1,300 babies are born too soon in the United States, according to the March of Dimes. Their early arrival puts them at greater risk of death and long-term medical complications, including lung and development disorders, than babies born between 38-42 weeks.

“We don’t fully understand why women go in to premature labor, and we don’t have good methods for stopping it,” says Ramin, director of the Maternal-Fetal Medicine division. “But we do have some very exciting news about a progesterone therapy that dramatically reduces recurrent premature birth in women who are at high risk.”

Mother’s Little Helper: Hormones

Although most women naturally produce large quantities of progesterone during pregnancy, boosting the progesterone level with injections appears to lessen the risk of preterm delivery.

Ramin, associate professor of Obstetrics, Gynecology and Reproductive Sciences, said the therapy isn’t yet covered by insurance, but physicians are offering it to mothers.

Women should begin progesterone therapy 16-20 weeks into their pregnancy and receive weekly injections until the 36th week, Ramin says. It can cost as much as $250 for the entire treatment.

Currently, patients must come to the doctor’s office for the injections, which may be an inconvenience, but Ramin expects that in the future, mothers-to-be may be able to do their own injections at home.

“This is a wonderful way to decrease the incidence of preterm births and increase the number of healthy babies who are born every day,” Ramin says.

UPDATED: 5-08-2003

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