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المؤلفAhmed, Badreldeen
المؤلفAbushama, Mandy
المؤلفKonje, Justin C.
تاريخ الإتاحة2024-05-14T08:06:56Z
تاريخ النشر2023-03-26
اسم المنشورJournal of Maternal-Fetal and Neonatal Medicine
المعرّفhttp://dx.doi.org/10.1080/14767058.2023.2183756
الاقتباسAhmed, B., Abushama, M., & Konje, J. C. (2023). Prevention of spontaneous preterm delivery–an update on where we are today. The Journal of Maternal-Fetal & Neonatal Medicine, 36(1), 2183756.
الرقم المعياري الدولي للكتاب1476-7058
معرّف المصادر الموحدhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85150971652&origin=inward
معرّف المصادر الموحدhttp://hdl.handle.net/10576/54976
الملخصSpontaneous preterm birth (delivery before 37 completed weeks) is the single most important cause of perinatal morbidity and mortality. The rate is increasing world-wide with a great disparity between low, middle and high income countries. It has been estimated that the cost of neonatal care for preterm babies is more than 4 times that of a term neonate admitted into the neonatal care. Furthermore, there are high costs associated with long-term morbidity in those who survive the neonatal period. Interventions to stop delivery once preterm labor starts are largely ineffective hence the best approach to reducing the rate and consequences is prevention. This is either primary (reducing or minimizing factors associated with preterm birth prior to and during pregnancy) or secondary - identification and amelioration (if possible) of factors in pregnancy that are associated with preterm labor. In the first category are optimizing maternal weight, promoting healthy nutrition, smoking cessation, birth spacing, avoidance of adolescent pregnancies and screening for and controlling various medical disorders as well as infections prior to pregnancy. Strategies in pregnancy, include early booking for prenatal care, screening and managing medical disorders and their complications, and identifying predisposing factors to preterm labor such as shortening of the cervix and timely instituting progesterone prophylaxis or cervical cerclage where appropriate. The use of biomarkers such as oncofetal fibronectin, placental alpha-macroglobulin-1 and IGFBP-1 where cervical screening is not available or to diagnosis PPROM would identify those that require close monitoring and allow the institution of antibiotics especially where infection is considered a predisposing factor. Irrespective of the approach to prevention, timing the administration of corticosteroids and where necessary tocolysis and magnesium sulfate are associated with an improved outcome. The role of genetics, infections and probiotics and how these emerging dimensions help in the diagnosis of preterm birth and consequently prevention are exciting and hopefully may identify sub-populations for targeted strategies.
راعي المشروعOpen Access funding provided by the Qatar National Library.
اللغةen
الناشرTaylor & Francis
الموضوعcervical insufficiency
Preterm labor
progesterone
العنوانPrevention of spontaneous preterm delivery–an update on where we are today
النوعArticle
رقم العدد1
رقم المجلد36
ESSN1476-4954
dc.accessType Open Access


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