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Updated: Jun 22, 2025
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Preterm birth in low-middle income Countries
Alim Swarray-Deen1, Perez Sepenu2, Teresa E Mensah3
1Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana; Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana.
Insights
Preterm birth (PTB) prevention is key, especially in low- and middle-income countries (LMIC). Targeted strategies and policy involvement are crucial for reducing PTB rates globally.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Neonatology
Background:
- Preterm birth (PTB) is a leading cause of infant morbidity and mortality worldwide.
- PTB rates remain disproportionately high in low- and middle-income countries (LMIC) compared to high-income countries (HIC).
- Complex and multifactorial pathogenesis of PTB necessitates targeted, rather than generalized, interventions.
Purpose of the Study:
- To review the current understanding of preterm birth prevention strategies.
- To emphasize the importance of phenotyping PTB for targeted prevention.
- To explore the role of policy makers in implementing evidence-based PTB reduction strategies in LMIC.
Main Methods:
- Review of existing literature on PTB and its prevention.
- Analysis of PTB trends and risk factors in HIC and LMIC.
- Discussion of evidence-based prevention strategies and their adaptability to LMIC settings.
Main Results:
- Phenotyping PTB has led to more effective targeted preventative approaches.
- Primary and secondary prevention strategies, including risk factor identification and management, are effective.
- Adaptable strategies from HIC require stakeholder involvement and LMIC-generated evidence for successful implementation in LMIC.
Conclusions:
- Prevention is the most effective approach to reducing PTB rates.
- Engaging policymakers and stakeholders is essential for translating evidence into effective PTB reduction policies in LMIC.
- Utilizing LMIC-generated evidence is crucial for developing sustainable PTB prevention programs in these regions.
Abstract:
Preterm birth (PTB), remains a major cause of significant morbidity and mortality world-wide with about 12-15million preterm births occurring every year. Although the overall trend is decreasing, this is mainly in high-income countries (HIC). The rate remains high in low-and middle-income countries (LMIC) varying on average between 10 and 12% compared to 9% in HIC. The pathogenesis of PTB is complex and multifactorial. Attempts to reduce rates that have focused on PTB as a single condition have in general been unsuccessful. However, more recent attempts to phenotype PTB have resulted in targeted preventative approaches which are yielding better results. Prevention (primary or secondary) is the only approach that has been shown to make a difference to rates of PTB. These include identifying risk factors pre-pregnancy and during pregnancy and instituting appropriate measures to address these. In LMIC, although some approaches that have been shown to be effective in some HIC are adaptable, there is a need to involve stakeholders at all levels in utilizing evidence preferrably generated in LMIC to implement strategies that are likely to reduce the rate of PTB. In this review, we focus on prevention and how to involve policy makers in the process of applying evidence into policy that would reduce PTB in LMIC.
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