Abstract
There is not a single or combined screening method for preterm birth with high sensitivity which will truly identify the women at risk for preterm birth while also with high specificity to prevent unnecessary interventions and high treatment costs. Measurement of cervical length is the most cost-effective method that is used in clinical practice. Bedside tests have also been developed for detecting markers like fetal fibronectin, insulin-like growth factor binding protein-1 (IGFBP-1), interleukin-6, and placental alpha-macroglobulin-1. Taking the maternal history, health condition, and sociodemographical factors into consideration is recommended. Ultrasound markers apart from cervical length measurements as uterocervical angle and placental strain ratio are studied. Investigations on metabolomics, proteomics, and microRNA profiling have brought a new aspect on this subject. Maybe in the future, with clear identification of women at true risk for preterm birth, development of more effective preventive strategies will not be unfeasible.
Highlights
Defined as delivery before completing 37 weeks of gestation, Preterm birth (PB) is caused by multiple etiologies as individual and environmental factors, which makes the prediction and prevention of PB a challenging process in antenatal care [1]
A recent study in an extensive population reported that universal cervical screening program during mid-trimester sonogram in women without a history of preterm birth was associated with reduction in the PB [29]
It was reported that risk for PB was higher in women with cervical dilatation, while short cervical length was independently associated with preterm birth [33]
Summary
Defined as delivery before completing 37 weeks of gestation, PB is caused by multiple etiologies as individual and environmental factors, which makes the prediction and prevention of PB a challenging process in antenatal care [1]. Preterm birth (PB) is an important subject for being one of the leading causes of neonatal mortality and its long term neurologic and developmental problems [1]. It is related with cerebral palsy, bronchopulmonary dysplasia, retinopathy of prematurity, and many other morbidities that come with the prematurity [1]. As underlying etiology of preterm labor is not completely clear, identification of risk factors and determining the individual risk for pregnant women have importance in obstetric management of women who may benefit from current treatment strategies [6] (Table 1)
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