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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Prevention of preterm birth
Jeffrey M Denney1, Jennifer F Culhane, Robert L Goldenberg
1University of Utah, Department of Obstetrics & Gynecology, Department of Maternal-Fetal Medicine, Salt Lake City, UT, USA. jeffrey.denny@hsc.utah.edu
Insights
Preterm birth rates are rising, driven by indicated and multiple births. More research is needed to identify which pregnant women benefit most from interventions to reduce spontaneous preterm birth.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Perinatal Medicine
Background:
- The US preterm birth rate approaches 13%, with increases linked to indicated preterm births and multiple births from assisted conception.
- Few interventions effectively prevent spontaneous preterm birth or mitigate risks for indicated preterm birth.
Purpose of the Study:
- To review current strategies for managing preterm birth.
- To identify the need for better patient stratification for interventions.
Main Methods:
- Literature review of obstetrical interventions and perinatal care strategies.
- Analysis of factors contributing to preterm birth rates.
Main Results:
- Corticosteroids for fetal maturation and regionalized perinatal care improve outcomes for preterm infants.
- Progesterone and cerclage show promise in reducing spontaneous preterm births.
Conclusions:
- While interventions improve outcomes for preterm infants, a critical need exists to define specific maternal populations who will benefit from preventative strategies.
- Further research is essential to optimize the application of existing and emerging interventions for preterm birth reduction.
Abstract:
The preterm birth rate in the USA is nearing 13%. The recent rise has been attributed to increased indicated preterm births and multiple births following artificial conceptions. There are few obstetrical interventions that successfully delay or prevent spontaneous preterm birth or reduce the risk factors leading to indicated preterm birth. On the other hand, there are many strategies that have improved outcomes for those infants who are born preterm. These include the use of corticosteroids for fetal maturation and regionalization of perinatal care for high-risk mothers and their infants. Several interventions, including progesterone use and cerclage, demonstrate promise in reducing spontaneous preterm births. The most pressing need is to better define the populations of pregnant women for whom these and other interventions will effectively reduce preterm birth.
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