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Medically indicated preterm birth: recognizing the importance of the problem

Cande V Ananth1, Anthony M Vintzileos

  • 1Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901-1977, USA. cande.ananth@umdnj.edu

Clinics in Perinatology
|February 19, 2008
PubMed

Insights

Preterm birth, especially medically indicated, is rising. Ischemic placental disease is a key factor, highlighting the need to evaluate risk factors for prediction and prevention.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Reproductive Health

Background:

  • Preterm birth (<37 weeks) affects over 500,000 US births annually, with a notable increase in medically indicated preterm births.
  • Medically indicated preterm births are often prompted by maternal/fetal conditions like preeclampsia, intrauterine growth restriction, and placental abruption, collectively termed "ischemic placental disease."

Purpose of the Study:

  • To investigate the role of ischemic placental disease in medically indicated preterm births.
  • To explore the heterogeneity of medically indicated preterm birth and ischemic placental disease for improved prediction and prevention strategies.

Main Methods:

  • Review of temporal trends in preterm birth rates.
  • Analysis of the association between ischemic placental disease and indicated preterm birth versus term birth.
  • Consideration of risk factors and syndrome heterogeneity.

Main Results:

  • Ischemic placental disease is implicated in over half of indicated preterm births, significantly more than term births.
  • A temporal increase in medically indicated preterm birth parallels the rise in preterm birth rates.
  • Understanding the diverse factors within medically indicated preterm birth and ischemic placental disease is crucial.

Conclusions:

  • Ischemic placental disease is a significant contributor to medically indicated preterm birth.
  • Further evaluation of risk factors and syndrome heterogeneity is essential for predicting and preventing preterm birth.

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