Preterm Birth
Most preterm births occur following preterm labor (PTL), preterm premature rupture of membranes (PPROM), or both. Such births are classified as spontaneous.
Spontaneous preterm birth may be considered the clinical endpoint of an injury or stimulus to the fetoplacental unit sufficient to trigger labor, membrane rupture, or both.
The remaining preterm deliveries are classified as indicated, which means they follow induction of labor or cesarean section undertaken because of a medical or an obstetric disorder that placed the gravida or the fetus at risk.
IN THIS SECTION
Preterm birth is considered a major problem in obstetrics today. Preterm birth is responsible for over half of newborn neurological problems.1
Prematurity in the U.S., puts a significant burden on the U.S. healthcare system. Employers are also affected by associated healthcare costs and reduced workplace productivity.
Many factors can cause or contribute to spontaneous preterm birth. Fetal fibronectin is the most powerful predictor of preterm birth <32 weeks in women at risk for preterm birth, when compared to traditional risk factors.2
ACOG clinical recommendations support the use of fetal fibronectin testing to help rule out women with symptoms who are at reduced risk of having a preterm birth, to help avoid unnecessary interventions.
The Agency for Healthcare Research and Quality reported in 2000 that both fetal fibronectin and endovaginal ultrasound present strong evidence of effectiveness as a diagnostic tool for assessing the risk of preterm birth.
Fetal fibronectin is the single, common biochemical marker for all four mechanisms of preterm birth.
In 2006, the Institute of Medicine called for a multidisciplinary research agenda to help improve prediction and prevention of preterm labor, and better understand the impact of preterm birth.
References
- 1. Goldenberg RL, Hauth JC, Andrews WW. Intrauterine infection and preterm delivery. N Engl J Med. 2001;342:1500-07.
- 2. Goldenberg RL, Iams JD, Mercer BM, et al. The preterm prediction study: the value of new vs. standard risk factors in predicting early and all spontaneous preterm births. Am J Public Health. 1998;88:233-38.