PREVENTION OF PRETERM DELIVERY
Keywords:
Preterm delivery – risk factors – prevention – pregnancy – progesterone – cerclajeAbstract
Preterm delivery is traditionally known as birth that occurs after 20 weeks and before completing 37 weeks of gestation; however, this definition is being reevaluated. In developed countries, preterm delivery is the primary cause of children mortality and it significantly increases their morbidity. It is fundamental to determine its predisposing factors, in order to detect mothers at risk and consequently, avoid this adverse outcome.
Some of the known risk factors for preterm delivery are: short cervical length, demographic characteristics, history of cervical surgery, previous preterm delivery, vaginal bleeding during the first trimester, obesity, infections, smoking, low preconceptional weight, substance abuse, and short interpregnancy interval.
On the other hand, some effective prevention measures may include: better prenatal control, antibiotic treatment for certain genital infections, in patients with premature rupture of membranes, and asymptomatic bacteriuria; supplementation of progesterone in patients with or without history of previous preterm delivery, but with very short cervical length before the 24th week of gestation, use of cervical cerclaje in women with history of preterm delivery before 34 weeks and cervical length less than 25 mm at 24 weeks of gestation, use of pessary in asymptomatic women without history of preterm delivery with incidental diagnosis of short cervix at 18-22 weeks of gestation, zinc supplementation in women with low income and malnutrition, and finally, interpregnancy interval longer than 12 months.
References
2. Practice bulletin no. 130: Prediction and Prevention of Preterm Birth. Committee on Practice Bulletins—Obstetrics, The American College of Obstetricians and Gynecologists. Obstet Gynecol. 2012; 120(4):964.
3. Shapiro-Mendoza CK, Barfield WD, Henderson Z, et al. CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth. MMWR Morb Mortal Wkly Rep 2016; 65:826.
4. Moroz LA, Simhan HN. Rate of sonographic cervical shortening and biologic pathways of spontaneous preterm birth. Am J Obstet Gynecol 2014; 210:555.e1.
5. Berkowitz GS, Kasl SV. The role of psychosocial factors in spontaneous preterm delivery. J Psychosom Res 1983; 27:283.
6. Ding XX, Wu YL, Xu SJ, et al. Maternal anxiety during pregnancy and adverse birth outcomes: a systematic review and meta-analysis of prospective cohort studies. J Affect Disord 2014; 159:103.
7. Sheiner E, Mazor-Drey E, Levy A. Asymptomatic bacteriuria during pregnancy. J Matern Fetal Neonatal Med 2009; 22:423.
8. Donders GG, Van Calsteren K, Bellen G, et al. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG 2009; 116:1315.
9. Han YW. Can oral bacteria cause pregnancy complications? Womens Health (Lond) 2011; 7:401.
10. Gravett MG, Novy MJ, Rosenfeld RG, et al. Diagnosis of intra-amniotic infection by proteomic profiling and identification of novel biomarkers. JAMA 2004; 292:462.
11. Buhimschi CS, Schatz F, Krikun G, et al. Novel insights into molecular mechanisms of abruptioninduced preterm birth. Expert Rev Mol Med 2010; 12:e35.
12. Adams Waldorf KM, Singh N, Mohan AR, et al. Uterine overdistention induces preterm labor mediated by inflammation: observations in pregnant women and nonhuman primates. Am J Obstet Gynecol 2015; 213:830.e1.
13. Lockwood CJ. Risk factors for preterm birth and new approaches to its early diagnosis. J Perinat Med 2015; 43:499.
14. Sciscione AC. Maternal activity restriction and the prevention of preterm birth. Am J Obstet Gynecol 2010; 202:232.e1.
15. Grobman, W., Gilbert, S., Iams, J., Spong, C., Saade, G., & Mercer, B. et al. (2013). Activity Restriction Among Women With a Short Cervix. Obstetrical & Gynecological Survey, 68(11), 725-727.
16. Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev 2017; 4:CD004905.
17. Buppasiri P, Lumbiganon P, Thinkhamrop J, et al. Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes. Cochrane Database Syst Rev 2015; :CD007079.
18. De-Regil LM, Palacios C, Lombardo LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2016; :CD008873.
19. Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Ann N Y Acad Sci 1993; 678:178.
20. Ota E, Mori R, Middleton P, et al. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev 2015; :CD000230.
21. Rumbold A, Ota E, Hori H, et al. Vitamin E supplementation in pregnancy. Cochrane Database Syst Rev 2015; :CD004069.
22. Institute of Medicine. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. The National Academies Press, Washington, DC 2006. https://www.nal.usda.gov/sites/default/files/fnic_uploads//DRIEssentialGuideNutReq.pdf (Accessed on December 12, 2016).
23. Xiong, X., Buekens, P., Fraser, W., Beck, J., & Offenbacher, S. (2006). Periodontal Disease and Adverse Pregnancy Outcomes: A Systematic Review. Obstetrical & Gynecological Survey, 61(5), 307-309. http://dx.doi.org/10.1097/01.ogx.0000216649.08213.84
24. Sanz, M., & Kornman, K. (2013). Periodontitis and adverse pregnancy outcomes: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal Of Periodontology, 84(4-s), S164-S169. http://dx.doi.org/10.1902/jop.2013.1340016.
25. Schwendicke F, Karimbux N, Allareddy V, Gluud C. Periodontal treatment for preventing adverse pregnancy outcomes: a meta- and trial sequential analysis. PLoS One 2015; 10:e0129060.
26. Klein, L., & Gibbs, R. (2004). Use of microbial cultures and antibiotics in the prevention of infection-associated preterm birth. American Journal Of Obstetrics And Gynecology, 190(6), 1493-1502. http://dx.doi.org/10.1016/j.ajog.2004.03.014
27. Manuck, T., Smeester, L., Martin, E., Smith, C., Varner, M., & Fry, R. (2017). 380: Midtrimester epigenetic modification in circulating blood: novel predictors of response to 17-alpha hydroxyprogesterone caproate (17P) for recurrent preterm birth (PTB) prevention. American Journal Of Obstetrics And Gynecology, 216(1), S228-S229. http://dx.doi.org/10.1016/j.ajog.2016.11.638
28. Rodriguez, M., Chang, R., & Thiel de Bocanegra, H. (2015). The impact of postpartum contraception on reducing preterm birth: findings from California. American Journal Of Obstetrics And Gynecology, 213(5), 703.e1-703.e6. http://dx.doi.org/10.1016/j.ajog.2015.07.033
Downloads
Published
Issue
Section
License
The intellectual property of accepted works belongs to their authors, however access to them is totally open and free, so they can be reproduced totally or partially with the only limitation of recognizing the authorship and the source of publication (Revista Medicina Legal de Costa Rica), as long as said exploitation does not have commercial character.
