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Risk assessment and management to prevent preterm birth.

B Koullali1, M A Oudijk1, T A J Nijman2

  • 1Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands.

Seminars in Fetal & Neonatal Medicine
|February 25, 2016
PubMed
Summary

Identifying women at risk of preterm birth is crucial for effective prevention. A history of preterm birth and mid-pregnancy cervical length are key predictors, guiding clinical management to reduce neonatal mortality.

Keywords:
Preterm birthPreventionRisk assessmentRisk factorsRisk reduction

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Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Reproductive Health

Background:

  • Preterm birth is a leading global cause of neonatal mortality and morbidity.
  • Effective prevention strategies are essential for improving infant outcomes worldwide.

Purpose of the Study:

  • To review potential risk factors for preterm birth.
  • To discuss management strategies for preventing preterm birth in various risk groups.
  • To identify key predictors for early intervention.

Main Methods:

  • Literature review of studies on preterm birth risk factors and prevention.
  • Analysis of general, pregnancy-related, and historical risk factors.
  • Evaluation of diagnostic tools like cervical length measurement and fetal fibronectin testing.

Main Results:

  • A history of preterm birth is the strongest predictor for subsequent pregnancies.
  • Mid-pregnancy cervical length measurement is a significant independent predictor of preterm birth.
  • General factors (ethnicity, SES, weight, smoking, periodontal status) have lower impact.
  • Pregnancy-related factors (bacterial vaginosis, asymptomatic bacteriuria) have limited predictive value.
  • Fetal fibronectin testing may offer additional predictive value.

Conclusions:

  • Identifying women at risk is paramount for effective preterm birth prevention.
  • Obstetric history and mid-pregnancy cervical length are critical for risk assessment.
  • Tailored prevention strategies based on individual risk profiles are necessary for clinical care.