What are Effective Interventions to Prevent Preterm Labor?

Fifteen million babies are born preterm each year, according to the National Institutes of Health (NIH). Preterm babies can face life-threatening, long-term health complications from underdeveloped systems. Preterm birth and its related complications are the largest causes of neonatal death worldwide.

According to Medscape Medical News, implementing preventive interventions could reduce the rate of preterm births by up to 5 percent, which might seem like a relatively small portion, but accounts for 58,000 preterm births per year. The three most effective preterm labor interventions are decreasing the numbers of medically unnecessary Caesarean deliveries, supplementation of progesterone and cervical cerclage.

Preventing Non-Medically Indicated Late Preterm Births

Late preterm births pose serious health concerns for infants. The late preterm period is between 34 weeks and 36 weeks 6 days. Late preterm births account for 70 percent of all preterm births, according to the NIH. Infants born in the late preterm window often suffer from physiological and metabolic immaturity. The brain mass of a late preterm infant is approximately 70 percent of an infant carried to full term.

Prevention of late preterm births can first be accomplished by limiting Caesarean deliveries and medically induced births to only the most necessary cases. Caesareans and medical inducing of labor have risen by 20 percent in past years. Studies conducted in 14 states across the U.S. saw when there was a reduction in the rate of elective deliveries, the rate of admissions to the newborn intensive care unit dropped 15 percent from 8.9 to 7.5 percent. The studies were conducted in 2013 by doctors Glavind and Henriksen.

Progesterone Supplementation

Progesterone supplementation has been suspected to help prevent preterm births for decades, and recent studies have offered strong proof in its favor. Experts are still unsure exactly why higher progesterone levels delay birth in human women. However, progesterone does have anti-inflammatory properties that could counteract the inflammatory process that initiates labor.

It is also possible that withdrawal of progesterone through changes in progesterone receptors and their transcriptional activity at a tissue level is responsible for slowing labor. Progesterone is shown to be especially effective in preventing preterm labor in women with short cervices, according to the NIH. This has led to questions from women’s health professionals about the need for cervical screening in pregnant women. But the costs associated have not yet made it a nationwide solution.

Cervical Cerclage

Cervical cerclage is the use of surgical sutures or tape on the cervix to prevent dilation and preterm labor. This procedure is only performed in the case of a history of preterm pregnancy, a shortened cervix shown during an ultrasound, or a shortened cervix found upon physical examination.

Compared with women who received no treatment, those who received cervical cerclage showed a 20 percent reduction in preterm births along with a reduction in perinatal deaths.

Prep for Board Exams

If you need additional prep for your OB/GYN CME board exams, be sure to take advantage of our online and audio courses! They can help if you were unable to attend one of our live conferences or if you just want a refresher.