Epidemiology of preterm labor: Α review of the literature

Antsaklis P, Papantoniou N, Mesogitis S, Antsaklis A.

1st Department of Obstetrics and Gynaecology, "Alexandra" Maternity Hospital, University of Athens, Greece.

Correspondence: Αntsaklis P, 11 Lampsakou Str., 11528 Αthens, Greece

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Abstract

In industrialized countries, 5-11% of infants are born preterm (<37 weeks' gestation), and the rate has been increasing since the early 1980s. Preterm births account for 65-75% of neonatal deaths and up to 75% of neonatal morbidity, and contribute to longterm neurocognitive deficits, pulmonary dysfunction and ophthalmologic disorders. In the past several decades, major progress has been made in improving the survival of extremely premature newborns, mostly attributable to timely access to effective interventions that ameliorate prematurity-associated mortality and morbidity such as antenatal administration of corticosteroids and exogenous surfactant therapy, rather than preventing preterm births. Survival rates amongst preterm infants have changed dramatically over the last decade, with 88% survival for 27-28 weeks, and 21% for > or =24 weeks (depending on birth weight). However, the societal and healthcare
costs to care for survivors with severe morbidity and neurological handicaps remain substantial. The diagnosis of preterm labour is difficult and most interventions to halt labour are unsuccessful. The purpose of this article is to study the epidemiologic characteristics of women who deliver their infants before term birth, which could provide clues to the cause of this most important obstetric problem and help to the understanding of preterm labour. Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such multiple pregnancy, fetal and uterine abnormalities.

Key words: preterm labour; risk factors; epidemiology.