Prevention of Preterm Birth

Jeffrey M. Denney; Jennifer F. Culhane; Robert L. Goldenberg

Disclosures

Women's Health. 2008;4(6):625-638. 

In This Article

Future Perspective

Historically, our attempts to effect a reduction in the incidence of preterm birth have been aimed at removing associated risk factors in the hope that removing the risk would, in turn, thwart the onset of preterm labor or membrane rupture. Such attempts have generally failed. Additional research focusing on contributing factors and how they lead toward preterm or term parturition will help us identify targets for prevention or treatment. Such knowledge will facilitate the design of clinical trials to ascertain potentially effective treatments. Until we have a better understanding of the underlying mechanisms on a cellular and molecular level, both derivation of effective treatments and achieving substantial reductions in preterm delivery are unlikely to occur. For instance, many recent studies have focused on the role of inflammatory processes in facilitating preterm births. Progesterone, a known anti-inflammatory agent, has been demonstrated to both reduce rates of preterm birth in select populations and to prevent inflammation-induced preterm birth in animal models.[93] Studies directed toward inflammation-mediated preterm labor by use of either immune or hormonal modulation may prove useful. More trials are needed in order to determine whether such agents will prove to affect the overall incidence of preterm birth.

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