AN ALARMING rise in the number of women giving birth prematurely risks overloading the NHS and may be linked to increases in obese and older mothers, according to doctors.

A study of more than 600,000 births over the past decade found that the number of deliveries occurring before nine months of pregnancy had increased by almost a quarter.

Researchers also found that among women without factors that normally increase the chances of a pre-term birth — such as fertility treatment, an earlier premature birth or cervical surgery — the rate had increased more than 50 per cent.

Leading obstetricians yesterday gave warning that the rise was likely to be replicated in “similar societies” such as Britain, although comprehensive data has yet to be collated. They said that the trend carried serious implications for the NHS with chronic illnesses such as diabetes, high blood pressure and heart disease linked to early deliveries.

Pre-term babies are also at greater risk of developing severe mental and physical disabilities. A quarter of babies born after 25 weeks or less have such problems, and a high number of children born at 32 weeks have educational and behavioural problems by the age of 7.

Although premature deliveries account for fewer than 1 in 10 births, they result in 75 per cent of neonatal deaths and most neonatal intensive care admissions.

Writing in an editorial accompanying the Danish study, published this week in the British Medical Journal, doctors said that it was essential that the exact causes of the growth were investigated.

Andrew Shennan, Professor of Obstetrics at King’s College London School of Medicine, at St Thomas’s Hospital, said that the growing number of women deciding to postpone having children and increasing female obesity were “good candidates” to explain the trends. More accurate ultrasound dating of conceptions might also play a role, he added.

“We know about the problems encountered with severely premature births, but I worry about the more subtle things that are clearly happening to a much larger number of babies, such as educational problems and chronic conditions like diabetes and hypertension,” Professor Shennan said. “If you want really to address the big health problems affecting society, this is where to start.”

Professor Shennan and his co-author, Susan Bewley, concluded that if the findings from Denmark were accurate the implications for neonatologists, health economists, teachers, parents, and children were worrying. “Premature babies are at great risk of death and disability, and the total health burden to the population will not change unless the number can be reduced,” he said.

The Danish study included four national birth registries of 646,000 deliveries — almost all live births — in Denmark between 1995 and 2004. The authors said that the prevalence of several premature birth risk factors — IVF, high maternal age, first-time mothers and elective early deliveries — have changed in recent years and may explain the increases in pre-term deliveries.

Concerns have been raised by many gynaecologists and obstetricians about the health impacts of the rapid rise of career women becoming pregnant later in life. Fertility problems increase after 35, and greatly so for women over 40.

According to the Office for National Statistics, the over-35s have the fastest-growing birthrates. Women having babies in their forties have nearly doubled in ten years. The number in their thirties is up by two thirds and outstrips those in their twenties.

Charlotte Davies, of the baby charity Tommy’s, said that research was urgently needed. “If this increase continues, and is extrapolated to the UK, then it’s very concerning and means that we need, more than ever, to work out exactly why it’s happening and bring in preventive measures.”

EARLY DELIVERIES

90 per cent of triplets and half of twins are premature

Triplet births have tripled in Britain and quadrupled in the US in the past 20 years

When the gap between births is short (less than 15 months) or longer than five years, the baby has a much greater chance of being premature or of low weight

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