Prevention of preterm birth.
Prevention of prematurity is the principal goal of all obstetric care. Although conquest of preterm births may yet be a distant goal that will require substantial improvements in understanding the pathophysiology of PTD, interim progress is possible. Increased attention to prematurity prevention as the focus of prenatal care can have an impact now, without introducing unproven or hazardous techniques or medication. Reproductive health care aimed at the prevention and elimination of social, demographic, and medical correlates of prematurity can yield results if obstetricians take the lead in educating both patients and society at large about the hazards of prematurity. Progress is more likely if a global strategy is used in all pregnancies as reported by Papiernik et al., Meis et al., and Herron et al. These studies have similar messages of hope and caution: All reported benefit in decreasing the frequency of preterm births, all required substantial and widespread patient and provider education, and all required a sustained effort before any effect was noted. Main et al. showed that these programs are not likely to produce a quick turnaround in PTD rates in all populations; progress will be slow. Reports of limited success or even failure should not result in abandonment of the goal, but rather in renewed and imaginative efforts toward it.
Iams
J D
JD
Department of Obstetrics and Gynecology, Ohio State University College of Medicine, Columbus 43210.
Johnson
F F
FF
Creasy
R K
RK
D001510:Bed Rest; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011295:Prenatal Care; D012307:Risk Factors