Recent advances in the prevention of preterm birth

Abstract

Preterm birth (PTB) remains a major obstetric healthcare problem and a significant contributor to perinatal morbidity, mortality, and long-term disability. Over the past few decades, the perinatal outcomes of preterm neonates have improved markedly through research and advances in neonatal care, whereas rates of spontaneous PTB have essentially remained static. However, research into causal pathways and new diagnostic and treatment modalities is now bearing fruit and translational initiatives are beginning to impact upon PTB rates. Successful PTB prevention requires a multifaceted approach, combining public health and educational programs, lifestyle modification, access to/optimisation of obstetric healthcare, effective prediction and diagnostic modalities, and the application of effective, targeted interventions. Progress has been made in some of these areas, although there remain areas of controversy and uncertainty. Attention is now being directed to areas where greater gains can be achieved. In this mini-review, we will briefly and selectively review a range of PTB prevention strategies and initiatives where progress has been made and where exciting opportunities await exploitation, evaluation, and implementation.

Menstrual symptoms and risk of preterm birth: A population‐based longitudinal study

“…These findings emphasize the potential clinical importance of reviewing women's menstrual symptoms in early pregnancy, especially among women in a second or subsequent pregnancy. In Australia, there have been recent efforts to reduce preterm births rates through increased health practitioner education and the implementation of evidenced‐based recommendations 49 . These recommendations reinforce the need to measure cervical length at all mid‐pregnancy morphology scans and to provide vaginal progesterone pessaries for women at risk based on their cervical length or maternal history 49 .…”

“…In Australia, there have been recent efforts to reduce preterm births rates through increased health practitioner education and the implementation of evidenced‐based recommendations 49 . These recommendations reinforce the need to measure cervical length at all mid‐pregnancy morphology scans and to provide vaginal progesterone pessaries for women at risk based on their cervical length or maternal history 49 . Currently, Australian health practitioners should counsel women based on these recommendations.…”

Importance of haemogram parameters for prediction of the time of birth in women diagnosed with threatened preterm labour

“…There have been many studies on the aetiology of preterm labour and prevention of preterm labour. 38 The exact aetiology of preterm birth is unknown. However, in Values are mean AE standard deviation.…”

Pessary cervical and prevention preterm birth based on literature review

“…It is an easy-touse, non-invasive, inexpensive tool that does not require anaesthesia and is potentially promising to reduce the risk of premature delivery in patients with risk factors. 2 So it is a possible alternative to cerclage and/or progesterone treatments. It has been used for this purpose since 1950.…”

“…It could correlate to a structural abnormality of the biochemical components of the cervical tissue that prevents the inhibition of its function as sphincter. 2 From the clinical point of view the cervical insufficiency is defined as a cervical painless dilation leading to recurrent pregnancy loss in the second term and premature delivery, depending on the specific characteristics of the cervix, in particular cervical length. 3 Under normal conditions the length of the cervix is stable between weeks 14 and 28 of gestation.…”