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

Interpregnancy Interval

There is a raised risk of preterm birth in pregnancies arising within close temporal proximity to a previous delivery. An inter-pregnancy interval of less than 6 months confers a greater than twofold increased risk of preterm birth after adjustment for confounding variables.[40,41] Furthermore, women whose first births were preterm are more likely to have a short interval than women who had a term first birth, thus compounding the risk. Although the mechanism is not clear, one potential explanation is that the uterus takes time to return to its normal state, including resolution of the inflammatory status associated with the previous pregnancy. Maternal depletion may be another cause, because pregnancy consumes maternal stores of essential vitamins, minerals and amino acids. A short interval decreases the opportunity to replenish these nutrients. Thus, increasing pregnancy spacing through the use of counseling and provision of contraceptives, especially in women with a prior preterm birth, is likely to reduce the risk of subsequent preterm birth. However, there is little clinical trial evidence to support this recommendation.

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