title: Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth.
abstract: Interventions to reduce the morbidity and mortality of preterm birth can be primary (directed to all women), secondary (aimed at eliminating or reducing existing risk), or tertiary (intended to improve outcomes for preterm infants). Most efforts so far have been tertiary interventions, such as regionalised care, and treatment with antenatal corticosteroids, tocolytic agents, and antibiotics. These measures have reduced perinatal morbidity and mortality, but the incidence of preterm birth is increasing. Advances in primary and secondary care, following strategies used for other complex health problems, such as cervical cancer, will be needed to prevent prematurity-related illness in infants and children.
authors.affiliation: Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH, USA. iams.1@osu.edu
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Culhane
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
mesh_terms: D005260:Female; D006291:Health Policy; D006801:Humans; D007231:Infant, Newborn; D018743:Perinatal Care / Q000379:methods; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D011295:Prenatal Care; D039401:Prenatal Nutritional Physiological Phenomena; D012307:Risk Factors; D015149:Tocolytic Agents / Q000627:therapeutic use*
chemical_list: D015149:Tocolytic Agents