From structural modalities in perinatal medicine to the frequency of preterm birth

Philipp Deindl, Anke Diemert, Philipp Deindl, Anke Diemert

Abstract

Preterm birth is a global health problem that affects 11% of all live births: it remains a significant cause of death and an important cause of long-term loss of human potential among survivors all around the world. In the last decade, many developed countries have seen an increase in the rate of infants born preterm. Various theoretical and practical concepts have been discussed that aim to optimize the perinatal care of preterm infants and their mothers. These include the definition of hospitals with different levels of care, the regionalization of care, the creation of large care units with high case numbers, and a high level of expertise. This review article focuses on the connection between health care structures and different aspects of preterm birth. Furthermore, this review article highlights the fact that preterm birth is a heterogeneous syndrome with many underlying pathologies and that the causality for a large number of cases remains unexplained. There is still a significant knowledge gap concerning the actual drivers of spontaneous preterm birth, and future research particularly in parturition immunology as well as genetics of prematurity will be essential to identify new targets for therapy.

Keywords: Cervical insufficiency; Genetics of prematurity; Immunology of parturition; Neonatal care; Prematurity; Prenatal care; Preterm birth; Progesterone; Risk factors prematurity.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Consequences of preterm birth stratified by medical short-term, medical long-term, and economic and social consequences
Fig. 2
Fig. 2
Structural modalities and the prevention of preterm birth—this figure summarizes strategies and recommendations for the prevention of preterm birth

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