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.

Related Concept Videos

Preventive Healthcare Services01:30

Preventive Healthcare Services

Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
Levels of Health Promotion and Illness Prevention01:26

Levels of Health Promotion and Illness Prevention

Health promotion allows a person to control the determinants of health, resulting in an improved health status. It enhances the quality of life and reduces premature deaths. Health promotion and illness prevention programs help people make beneficial choices to reduce the risk of disease and disabilities. There are three health promotion and illness prevention levels: primary, secondary, and tertiary prevention.
In primary prevention, actions taken before disease onset prevent the disease from...
Healthcare Associated Infections II: Preventive Measures01:22

Healthcare Associated Infections II: Preventive Measures

Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Development of the Oral Microbiota01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
Birth Control Methods01:22

Birth Control Methods

Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although vasectomy...
Pneumonia V: Nursing management and Prevention01:30

Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.