[Preterm delivery: detection of risks and preventive treatment]

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Public Health

Context:

• Approximately 13 million premature births occur globally each year, disproportionately affecting developing nations and contributing significantly to perinatal morbidity and mortality.
• Existing scientific literature was reviewed to identify effective interventions for preventing preterm birth and mitigating its neonatal consequences.

Purpose:

• To analyze scientifically validated data on interventions aimed at preventing preterm deliveries and reducing their impact on neonatal health.
• To evaluate the efficacy of various strategies, including risk factor identification, prevention, treatment of preterm labor, and prevention of neonatal respiratory distress syndrome.

Summary:

• Few methods effectively predict, prevent, or enable early detection of preterm delivery risk.
• Recommended interventions include screening and treating asymptomatic bacteriuria in all pregnancies and bacterial vaginosis in women with a history of preterm birth.
• Prophylactic cerclage is beneficial for women with multiple prior preterm births. Tocolytics (betamimetics, indomethacin) can delay delivery, while antenatal corticosteroids promote fetal lung maturation, reducing neonatal respiratory distress syndrome and mortality.

Impact:

• Screening for and treating asymptomatic bacteriuria and bacterial vaginosis are recommended for all pregnant women.
• Antenatal corticosteroid administration significantly reduces neonatal mortality by improving fetal lung maturity.
• Continued research is crucial for understanding preterm birth mechanisms and developing novel prevention and treatment strategies.