In the United States alone, 1 out of every 10 infants is born prematurely. While this might not initially seem to be very significant, this statistic entails hundreds of thousands of infants born prematurely every year. Premature infant birth can cause a myriad of problems – ranging from mild consequences, like small body size, to more severe ones, respiratory distress. Even further, babies born prematurely are more likely to die in their first year alive than babies born according to term. 

If you are a pregnant woman, these facts may scare you. However, there may be a simple fix – the next time someone offers you a stick of sugar-free gum, accept their offer. 

More specifically, xylitol gum, in a large study in Malawi, has been shown to reduce preterm births. In the study, 36.6% of women who did not receive the gum birthed their babies preterm, while only 12.6% of women who regularly chewed xylitol gum birthed their babies preterm, displaying a 24% decrease in preterm births. 

Despite it being a simple solution, the mechanism for xylitol as a saver of infant life is more complex. Oral bacteria is one of the largest hubs for bacteria life in your body; second only to gut flora. However, harmful bacteria growth poses the risk of infected gum tissue, which leads to bacterial infection of the bloodstream and internal organs, including the placenta in pregnant mothers. Although the scientific reasoning is still shaky, certain bacterial infections of the placenta originating from oral flora may cause complications leading to premature childbirth.

Even more technically, xylitol affects the energy-production processes of oral bacteria, such as Streptococcus mutans (MS). When xylitol is consumed by MS bacteria, MS transports the xylitol sugar into the cell using facilitated diffusion, and transports it via the same processes that happen to control growth inhibition. Xylitol is converted to xylitol-5-phosphate, which MS then dephosphorylates. After, the bacteria expels this dephosphorylated molecule out of the cell actively, requiring energy. However, the metabolism of xylitol by MS does not provide it with any significant energy as a product. Thus, MS repeats this process until it starves to death due to lack of energy, as MS is not taking in enough energy to meet its energy demands from xylitol metabolism. 

In conclusion, chewing xylitol gum as a treatment for premature childbirth has yielded promising results thus far. And due to its high efficacy to cost ratio and high availability, chewing xylitol gum seems to be an effective treatment for premature childbirth in poorer nations like Malawi. Xylitol chewing gums