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Strategies to Prevent Preterm Birth

Profile image of Catherine ArreseCatherine ArreseProfile image of Jeff A KeelanJeff A KeelanProfile image of Roger HartRoger Hart

2014, Frontiers in Immunology

https://doi.org/10.3389/FIMMU.2014.00584
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12 pages

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Abstract

After several decades of research, we now have evidence that at least six interventions are suitable for immediate use in contemporary clinical practice within high-resource settings and can be expected to safely reduce the rate of preterm birth. These interventions involve strategies to prevent non-medically indicated late preterm birth; use of maternal progesterone supplementation; surgical closure of the cervix with cerclage; prevention of exposure of pregnant women to cigarette smoke; judicious use of fertility treatments; and dedicated preterm birth prevention clinics. Quantification of the extent of success is difficult to predict and will be dependent on other clinical, cultural, societal, and economic factors operating in each environment. Further success can be anticipated in the coming years as other research discoveries are translated into clinical practice, including new approaches to treating intra-uterine infection, improvements in maternal nutrition, and lifestyle modifications to ameliorate maternal stress. The widespread use of human papillomavirus vaccination in girls and young women will decrease the need for surgical interventions on the cervix and can be expected to further reduce the risk of early birth. Together, this array of clinical interventions, each based on a substantial body of evidence, is likely to reduce rates of preterm birth and prevent death and disability in large numbers of children. The process begins with an acceptance that early birth is not an inevitable and natural feature of human reproduction. Preventative strategies are now available and need to be applied. The best outcomes may come from developing integrated strategies designed specifically for each health-care environment.

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References (128)

  1. Chang HH, Larson J, Blencowe H, Spong CY, Howson CP, Cairns-Smith S, et al. Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. Lancet (2013) 381:223-34. doi:10.1016/S0140-6736(12)61856-X
  2. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analy- sis and implications. Lancet (2012) 379:2162-72. doi:10.1016/S0140-6736(12) 60820-4
  3. Lawn JE, Cousens S, Zupan J, Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? where? why? Lancet (2005) 365:891-900. doi:10.1016/S0140-6736(05)71048-5
  4. Simmons LE, Rubens CE, Darmstadt GL, Gravett MG. Preventing preterm birth and neonatal mortality: exploring the epidemiology, causes, and interventions. Semin Perinatol (2010) 34:408-15. doi:10.1053/j.semperi.2010.09.005
  5. Xiao X-F, Wen Y-B, Chen K-C. Analysis of the birth surveillance in Shantou City from 1990 to 1999. J Clin Res (2004) 21:1246-66.
  6. Chen ML, Huang S-Y, Wang ZL. The trend of the incidence of preterm delivery and associated obstetrical factors in thirty years. Acad J SUMS (2001) 22(1): 68-72.
  7. Yang G, Jiang X, Zeng W. The analysis and investigation of premature delivery in Chengdu from 1998 to 1999. Sichuan Med J (2004) 25:1068-71.
  8. Dong H, Mao MJ, Li Y. The analysis and investigation of premature delivery in Jiaxing from 1993 to 1996. Lit Inf Prev Med (2001) 7:409-18.
  9. Newnham JP, Sahota DS, Zhang CY, Xu B, Zheng M, Doherty DA, et al. Preterm birth rates in Chinese women in China, Hong Kong and Australia - the price of Westernisation. Aust N Z J Obstet Gynaecol (2011) 51:426-31. doi:10.1111/j.1479-828X.2011.01327.x
  10. Guendelman S, English PB. Effect of United States residence on birth outcomes among Mexican immigrants: an exploratory study. Am J Epidemiol (1995) 142:S30-8. doi:10.1093/aje/142.Supplement_9.S30
  11. Clark SL, Frye DR, Meyers JA, Belfort MA, Dildy GA, Kofford S, et al. Reduction in elective delivery at <39 weeks of gestation: comparative effec- tiveness of 3 approaches to change and the impact on neonatal intensive care admission and stillbirth. Am J Obstet Gynecol (2010) 203(449):e441-6. doi:10.1016/j.ajog.2010.05.036
  12. Hassan SS, Romero R, Vidyadhari D, Fusey S, Baxter JK, Khandelwal M, et al. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo- controlled trial. Ultrasound Obstet Gynecol (2011) 38:18-31. doi:10.1002/uog. 9017
  13. Alfirevic Z, Stampalija T, Roberts D, Jorgensen AL. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database Syst Rev (2012) 4:CD008991. doi:10.1002/14651858.CD008991.pub2
  14. Hammoud AO, Bujold E, Sorokin Y, Schild C, Krapp M, Baumann P. Smok- ing in pregnancy revisited: findings from a large population-based study. Am J Obstet Gynecol (2005) 192:1856-62; discussion 1862-3. doi:10.1016/j.ajog. 2004.12.057
  15. Been JV, Nurmatov UB, Cox B, Nawrot TS, van Schayck CP, Sheikh A. Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis. Lancet (2014) 383:1549-60. doi:10.1016/S0140-6736(14) 60082-9
  16. Grady R, Alavi N, Vale R, Khandwala M, McDonald SD. Elective single embryo transfer and perinatal outcomes: a systematic review and meta-analysis. Fertil Steril (2012) 97:324-31. doi:10.1016/j.fertnstert.2011.11.033
  17. Whitworth M, Quenby S, Cockerill RO, Dowswell T. Specialised antenatal clin- ics for women with a pregnancy at high risk of preterm birth (excluding multi- ple pregnancy) to improve maternal and infant outcomes. Cochrane Database Syst Rev (2011) 9:CD006760. doi:10.1002/14651858.CD006760.pub2
  18. Engle WA, Tomashek KM, Wallman C, Committee on F, Newborn AAoP. "Late-preterm" infants: a population at risk. Pediatrics (2007) 120:1390-401. doi:10.1542/peds.2007-2952
  19. Shapiro-Mendoza CK, Lackritz EM. Epidemiology of late and moderate preterm birth. Semin Fetal Neonatal Med (2012) 17:120-5. doi:10.1016/j.siny. 2012.01.007
  20. Barros FC, Velez Mdel P. Temporal trends of preterm birth subtypes and neonatal outcomes. Obstet Gynecol (2006) 107:1035-41. doi:10.1097/01.AOG. 0000215984.36989.5e
  21. Papiernik E, Zeitlin J, Rivera L, Bucourt M, Topuz B. Preterm birth in a French population: the importance of births by medical decision. BJOG (2003) 110:430-2. doi:10.1046/j.1471-0528.2003.02323.x
  22. Morris JM, Algert CS, Falster MO, Ford JB, Kinnear A, Nicholl MC, et al. Trends in planned early birth: a population-based study. Am J Obstet Gynecol (2012) 207(186):e181-8. doi:10.1016/j.ajog.2012.06.082
  23. Doan E, Gibbons K, Tudehope D. The timing of elective caesarean deliveries and early neonatal outcomes in singleton infants born 37-41 weeks' gestation. Aust N Z J Obstet Gynaecol (2014) 54(4):340-7. doi:10.1111/ajo.12220
  24. Engle WA, Kominiarek MA. Late preterm infants, early term infants, and tim- ing of elective deliveries. Clin Perinatol (2008) 35:325-41, vi. doi:10.1016/j.clp. 2008.03.003
  25. Safe L, Hibbard JU, Wilkins I, Sun L, Gregory K, Haberman S, et al. Respiratory morbidity in late preterm births. JAMA (2010) 304:419-25. doi:10.1001/jama. 2010.1015
  26. Himmelmann K, Hagberg G, Beckung E, Hagberg B, Uvebrant P. The chang- ing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth-year period 1995-1998. Acta Paediatr (2005) 94:287-94. doi:10.1080/ 08035250410023313
  27. Pietz J, Peter J, Graf R, Rauterberg-Ruland I, Rupp A, Sontheimer D, et al. Physical growth and neurodevelopmental outcome of nonhandicapped low- risk children born preterm. Early Hum Dev (2004) 79:131-43. doi:10.1016/j. earlhumdev.2004.05.001
  28. Santos IS, Matijasevich A, Domingues MR, Barros AJ, Victora CG, Barros FC. Late preterm birth is a risk factor for growth faltering in early childhood: a cohort study. BMC Pediatr (2009) 9:71. doi:10.1186/1471-2431-9-71
  29. Holmqvist P, Regefalk C, Svenningsen NW. Low risk vaginally born preterm infants: a four year psychological and neurodevelopmental follow-up study. J Perinat Med (1987) 15:61-72. doi:10.1515/jpme.1987.15.1.61
  30. McCormick MC, Workman-Daniels K, Brooks-Gunn J. The behavioral and emotional well-being of school-age children with different birth weights. Pedi- atrics (1996) 97:18-25.
  31. Robinson M, Whitehouse AJ, Zubrick SR, Pennell CE, Jacoby P, McLean NJ, et al. Delivery at 37 weeks' gestation is associated with a higher risk for child behavioural problems. Aust N Z J Obstet Gynaecol (2013) 53:143-51. doi:10.1111/ajo.12012
  32. Gray RF, Indurkhya A, McCormick MC. Prevalence, stability, and predictors of clinically significant behavior problems in low birth weight children at 3, 5, and 8 years of age. Pediatrics (2004) 114:736-43. doi:10.1542/peds.2003-1150-L
  33. Spong CY. Defining "term" pregnancy: recommendations from the Defining "Term" Pregnancy Workgroup. JAMA (2013) 309:2445-6. doi:10.1001/jama. 2013.6235
  34. Brown HK, Speechley KN, Macnab J, Natale R, Campbell MK. Neonatal mor- bidity associated with late preterm and early term birth: the roles of gesta- tional age and biological determinants of preterm birth. Int J Epidemiol (2014) 43:802-14. doi:10.1093/ije/dyt251
  35. Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med (2009) 360:111-20. doi:10.1056/NEJMoa0803267
  36. Davidoff MJ, Dias T, Damus K, Russell R, Bettegowda VR, Dolan S, et al. Changes in the gestational age distribution among U.S. singleton births: impact on rates of late preterm birth, 1992 to 2002. Semin Perinatol (2006) 30:8-15. doi:10.1053/j.semperi.2006.01.009
  37. Glavind J, Kindberg SF, Uldbjerg N, Khalil M, Moller AM, Mortensen BB, et al. Elective caesarean section at 38 weeks versus 39 weeks: neonatal and mater- nal outcomes in a randomised controlled trial. BJOG (2013) 120:1123-32. doi:10.1111/1471-0528.12278
  38. Glavind J, Henriksen TB, Kindberg SF, Uldbjerg N. Randomised trial of planned caesarean section prior to versus after 39 weeks: unscheduled deliv- eries and facility logistics -a secondary analysis. PLoS One (2013) 8:e84744. doi:10.1371/journal.pone.0084744
  39. Zakar T, Hertelendy F. Progesterone withdrawal: key to parturition. Am J Obstet Gynecol (2007) 196:289-96. doi:10.1016/j.ajog.2006.09.005
  40. Astle S, Slater DM, Thornton S. The involvement of progesterone in the onset of human labour. Eur J Obstet Gynecol Reprod Biol (2003) 108:177-81. doi:10.1016/S0301-2115(02)00422-0
  41. Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF III, Petraglia F. Inflammation and pregnancy. Reprod Sci (2009) 16:206-15. doi:10.1177/ 1933719108329095
  42. Zakar T, Mesiano S. How does progesterone relax the uterus in pregnancy? N Engl J Med (2011) 364:972-3. doi:10.1056/NEJMcibr1100071
  43. Pieber D, Allport VC, Hills F, Johnson M, Bennett PR. Interactions between progesterone receptor isoforms in myometrial cells in human labour. Mol Hum Reprod (2001) 7:875-9. doi:10.1093/molehr/7.9.875
  44. Norwitz ER, Caughey AB. Progesterone supplementation and the prevention of preterm birth. Rev Obstet Gynecol (2011) 4:60-72. doi:10.3909/riog0163
  45. Levy T, Gurevitch S, Bar-Hava I, Ashkenazi J, Magazanik A, Homburg R, et al. Pharmacokinetics of natural progesterone administered in the form of a vagi- nal tablet. Hum Reprod (1999) 14:606-10. doi:10.1093/humrep/14.3.606
  46. Dodd JM, Jones L, Flenady V, Cincotta R, Crowther CA. Prenatal adminis- tration of progesterone for preventing preterm birth in women considered to be at risk of preterm birth. Cochrane Database Syst Rev (2013) 7:CD004947. doi:10.1002/14651858.CD004947.pub3
  47. Society for Maternal Fetal Medicine Publications C. ACOG Committee Opin- ion number 419 October 2008 (replaces no. 291, November 2003). Use of progesterone to reduce preterm birth. Obstet Gynecol (2008) 112:963-5. doi:10.1097/AOG.0b013e31818b1ff6
  48. Romero R, Nicolaides K, Conde-Agudelo A, Tabor A, O'Brien JM, Cetingoz E, et al. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data. Am J Obstet Gynecol (2012) 206(124):e1-19. doi:10.1016/j.ajog.2011.12.003
  49. Werner EF, Han CS, Pettker CM, Buhimschi CS, Copel JA, Funai EF, et al. Uni- versal cervical-length screening to prevent preterm birth: a cost-effectiveness analysis. Ultrasound Obstet Gynecol (2011) 38:32-7. doi:10.1002/uog.8911
  50. Society for Maternal-Fetal Medicine Publications Committee waoVB. Prog- esterone and preterm birth prevention: translating clinical trials data into clinical practice. Am J Obstet Gynecol (2012) 206:376-86. doi:10.1016/j.ajog. 2012.03.010
  51. Shirodkar V. A new method of operative treatment for habitual abortions in the second trimester of pregnancy. Antiseptic (1955) 52:299-300.
  52. McDonald I. Suture of the cervix for inevitable miscarriage. J Obstet Gynecol Br Emp (1957) 64:346-53. doi:10.1111/j.1471-0528.1957.tb02650.x
  53. Keeler SM, Kiefer D, Rochon M, Quinones JN, Novetsky AP, Rust O. A random- ized trial of cerclage vs. 17 alpha-hydroxyprogesterone caproate for treatment of short cervix. J Perinat Med (2009) 37:473-9. doi:10.1515/JPM.2009.083
  54. Conde-Agudelo A, Romero R, Nicolaides K, Chaiworapongsa T, O'Brien JM, Cetingoz E, et al. Vaginal progesterone vs. cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix, previous preterm birth, and singleton gestation: a systematic review and indirect comparison metaanalysis. Am J Obstet Gynecol (2013) 208:e41-2. doi:10.1016/j.ajog.2012. 10.877
  55. Arabin B, Alfirevic Z. Cervical pessaries for prevention of spontaneous preterm birth: past, present and future. Ultrasound Obstet Gynecol (2013) 42:390-9. doi:10.1002/uog.12540
  56. Kramer MS. Intrauterine growth and gestational duration determinants. Pedi- atrics (1987) 80:502-11.
  57. Williams LA, Evans SF, Newnham JP. Prospective cohort study of factors influ- encing the relative weights of the placenta and the newborn infant. BMJ (1997) 314:1864-8. doi:10.1136/bmj.314.7098.1864
  58. Best D. Committee on Environmental H, Committee on Native American Child H, Committee on A. From the American Academy of Pediatrics: Technical report -Secondhand and prenatal tobacco smoke exposure. Pediatrics (2009) 124:e1017-44. doi:10.1542/peds.2009-2120
  59. Tong VT, England LJ, Dietz PM, Asare LA. Smoking patterns and use of ces- sation interventions during pregnancy. Am J Prev Med (2008) 35:327-33. doi:10.1016/j.amepre.2008.06.033
  60. Tappin DM, MacAskill S, Bauld L, Eadie D, Shipton D, Galbraith L. Smoking prevalence and smoking cessation services for pregnant women in Scotland. Subst Abuse Treat Prev Policy (2010) 5:1. doi:10.1186/1747-597X-5-1
  61. Johnston V, Thomas DP, McDonnell J, Andrews RM. Maternal smoking and smoking in the household during pregnancy and postpartum: findings from an Indigenous cohort in the Northern Territory. Med J Aust (2011) 194:556-9.
  62. Tong VT, Dietz PM, England LJ, Farr SL, Kim SY, D'Angelo D, et al. Age and racial/ethnic disparities in prepregnancy smoking among women who deliv- ered live births. Prev Chronic Dis (2011) 8:A121.
  63. Bush J, White M, Kai J, Rankin J, Bhopal R. Understanding influences on smok- ing in Bangladeshi and Pakistani adults: community based, qualitative study. BMJ (2003) 326:962. doi:10.1136/bmj.326.7396.962
  64. Chamberlain C, O'Mara-Eves A, Oliver S, Caird JR, Perlen SM, Eades SJ, et al. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev (2013) 10:CD001055. doi:10.1002/ 14651858.CD001055.pub4
  65. Shah NR, Bracken MB. A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am J Obstet Gynecol (2000) 182:465-72. doi:10.1016/S0002-9378(00) 70240-7
  66. Coleman T, Chamberlain C, Davey MA, Cooper SE, Leonardi-Bee J. Phar- macological interventions for promoting smoking cessation during preg- nancy. Cochrane Database Syst Rev (2012) 9:CD010078. doi:10.1002/14651858. CD010078
  67. Kulkarni AD, Jamieson DJ, Jones HW Jr, Kissin DM, Gallo MF, Macaluso M, et al. Fertility treatments and multiple births in the United States. N Engl J Med (2013) 369:2218-25. doi:10.1056/NEJMoa1301467
  68. Gleicher N, Oleske DM, Tur-Kaspa I, Vidali A, Karande V. Reducing the risk of high-order multiple pregnancy after ovarian stimulation with gonadotropins. N Engl J Med (2000) 343:2-7. doi:10.1056/NEJM200007063430101
  69. Macaldowie A, Wang YA, Chambers GM, Sullivan EA. Assisted Reproductive Technology in Australia and New Zealand 2011. The University of New South Wales: National Perinatal Epidemiology Statistics Unit (2013).
  70. Hart R, Norman RJ. The longer-term health outcomes for children born as a result of IVF treatment: Part I -general health outcomes. Hum Reprod Update (2013) 19:232-43. doi:10.1093/humupd/dmt002
  71. Halliday J. Outcomes of IVF conceptions: are they different? Best Pract Res Clin Obstet Gynaecol (2007) 21:67-81. doi:10.1016/j.bpobgyn.2006.08.004
  72. Helmerhorst FM, Perquin DA, Donker D, Keirse MJ. Perinatal outcome of sin- gletons and twins after assisted conception: a systematic review of controlled studies. BMJ (2004) 328:261. doi:10.1136/bmj.37957.560278.EE
  73. Basso O, Baird DD. Infertility and preterm delivery, birthweight, and caesarean section: a study within the Danish National Birth Cohort. Hum Reprod (2003) 18:2478-84. doi:10.1093/humrep/deg444
  74. Zhu JL, Obel C, Hammer Bech B, Olsen J, Basso O. Infertility, infertility treatment, and fetal growth restriction. Obstet Gynecol (2007) 110:1326-34. doi:10.1097/01.AOG.0000290330.80256.97
  75. Raatikainen K, Kuivasaari-Pirinen P, Hippelainen M, Heinonen S. Compar- ison of the pregnancy outcomes of subfertile women after infertility treat- ment and in naturally conceived pregnancies. Hum Reprod (2012) 27:1162-9. doi:10.1093/humrep/des015
  76. Allen VM, Wilson RD, Cheung A. Genetics Committee of the Society of O, Gynaecologists of C, Reproductive Endocrinology Infertility Committee of the Society of O, Gynaecologists of C. Pregnancy outcomes after assisted repro- ductive technology. J Obstet Gynaecol Can (2006) 28:220-50.
  77. Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in sin- gletons following in vitro fertilization: a meta-analysis. Obstet Gynecol (2004) 103:551-63. doi:10.1097/01.AOG.0000114989.84822.51
  78. Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertil Steril (2012) 98(368- 377):e361-9. doi:10.1016/j.fertnstert.2012.05.019
  79. Sullivan EA, Wang YA, Hayward I, Chambers GM, Illingworth P, McBain J, et al. Single embryo transfer reduces the risk of perinatal mortality, a population study. Hum Reprod (2012) 27:3609-15. doi:10.1093/humrep/ des315
  80. Schachter M, Raziel A, Friedler S, Strassburger D, Bern O, Ron-El R. Monozy- gotic twinning after assisted reproductive techniques: a phenomenon inde- pendent of micromanipulation. Hum Reprod (2001) 16:1264-9. doi:10.1093/ humrep/16.6.1264
  81. Das S, Blake D, Farquhar C, Seif MM. Assisted hatching on assisted con- ception (IVF and ICSI). Cochrane Database Syst Rev (2009) 2:CD001894. doi:10.1002/14651858.CD001894.pub4
  82. Chang HJ, Lee JR, Jee BC, Suh CS, Kim SH. Impact of blastocyst transfer on offspring sex ratio and the monozygotic twinning rate: a systematic review and meta-analysis. Fertil Steril (2009) 91:2381-90. doi:10.1016/j.fertnstert. 2008.03.066
  83. Hansen M, Bower C, Milne E, de Klerk N, Kurinczuk JJ. Assisted reproductive technologies and the risk of birth defects -a systematic review. Hum Reprod (2005) 20:328-38. doi:10.1093/humrep/deh593
  84. Hobel CJ, Ross MG, Bemis RL, Bragonier JR, Nessim S, Sandhu M, et al. The West Los Angeles Preterm Birth Prevention Project. I. Program impact on high-risk women. Am J Obstet Gynecol (1994) 170:54-62.
  85. Sharp AN, Alfirevic Z. Provision and practice of specialist preterm labour clin- ics: a UK survey of practice. BJOG (2014) 121:417-21. doi:10.1111/1471-0528. 12512
  86. Lamont RF. Setting up a preterm prevention clinic: a practical guide. BJOG (2006) 113(Suppl 3):86-92. doi:10.1111/j.1471-0528.2006.01130.x
  87. Manuck TA, Henry E, Gibson J, Varner MW, Porter TF, Jackson GM, et al. Preg- nancy outcomes in a recurrent preterm birth prevention clinic. Am J Obstet Gynecol (2011) 204(320):e321-6. doi:10.1016/j.ajog.2011.01.011
  88. Markham KB, Walker H, Lynch CD, Iams JD. Preterm birth rates in a prematu- rity prevention clinic after adoption of progestin prophylaxis. Obstet Gynecol (2014) 123:34-9. doi:10.1097/AOG.0000000000000048
  89. Hobel CJ, Dunkel-Schetter C, Roesch SC, Castro LC,Arora CP. Maternal plasma corticotropin-releasing hormone associated with stress at 20 weeks' gesta- tion in pregnancies ending in preterm delivery. Am J Obstet Gynecol (1999) 180:S257-63. doi:10.1016/S0002-9378(99)70712-X
  90. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet (2008) 371:75-84. doi:10.1016/S0140-6736(08)60074-4
  91. Romero R, Gotsch F, Pineles B, Kusanovic JP. Inflammation in pregnancy: its roles in reproductive physiology, obstetrical complications, and fetal injury. Nutr Rev (2007) 65:S194-202. doi:10.1301/nr.2007.dec.S194-S202
  92. Kim SM, Romero R, Lee J, Mi Lee S, Park CW, Shin Park J, et al. The fre- quency and clinical significance of intra-amniotic inflammation in women with preterm uterine contractility but without cervical change: do the diag- nostic criteria for preterm labor need to be changed? J Matern Fetal Neonatal Med (2012) 25:1212-21. doi:10.3109/14767058.2011.629256
  93. DiGiulio DB. Diversity of microbes in amniotic fluid. Semin Fetal Neonatal Med (2012) 17:2-11. doi:10.1016/j.siny.2011.10.001
  94. Moss TJ, Nitsos I, Ikegami M, Jobe AH, Newnham JP. Experimental intrauter- ine Ureaplasma infection in sheep. Am J Obstet Gynecol (2005) 192:1179-86. doi:10.1016/j.ajog.2004.11.063
  95. Moss TJ, Knox CL, Kallapur SG, Nitsos I, Theodoropoulos C, Newnham JP, et al. Experimental amniotic fluid infection in sheep: effects of Ureaplasma parvum serovars 3 and 6 on preterm or term fetal sheep. Am J Obstet Gynecol (2008) 198(122):e121-8. doi:10.1016/j.ajog.2007.06.065
  96. Kramer BW, Kallapur S, Newnham J, Jobe AH. Prenatal inflammation and lung development. Semin Fetal Neonatal Med (2009) 14:2-7. doi:10.1016/j. siny.2008.08.011
  97. Grigsby PL, Novy MJ, Sadowsky DW, Morgan TK, Long M, Acosta E, et al. Maternal azithromycin therapy for Ureaplasma intraamniotic infection delays preterm delivery and reduces fetal lung injury in a primate model. Am J Obstet Gynecol (2012) 207:e471-5. doi:10.1016/j.ajog.2012.10.871
  98. Srinivasan S, Hoffman NG, Morgan MT, Matsen FA, Fiedler TL, Hall RW, et al. Bacterial communities in women with bacterial vaginosis: high resolution phy- logenetic analyses reveal relationships of microbiota to clinical criteria. PLoS One (2012) 7:e37818. doi:10.1371/journal.pone.0037818
  99. McDonald HM, Brocklehurst P, Gordon A. Antibiotics for treating bacter- ial vaginosis in pregnancy. Cochrane Database Syst Rev (2007) 1:CD000262. doi:10.1002/14651858.CD000262.pub3
  100. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacter- ial vaginosis: a systematic review. Am J Obstet Gynecol (2013) 209:505-23. doi:10.1016/j.ajog.2013.05.006
  101. Barros FC, Bhutta ZA, Batra M, Hansen TN, Victora CG, Rubens CE, et al. Global report on preterm birth and stillbirth (3 of 7): evidence for effec- tiveness of interventions. BMC Pregnancy Childbirth (2010) 10(Suppl 1):S3. doi:10.1186/1471-2393-10-S1-S3
  102. Mercer B. Antibiotics in the management of PROM and preterm labor. Obstet Gynecol Clin North Am (2012) 39:65-76. doi:10.1016/j.ogc.2011.12.007
  103. Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics for treating bacte- rial vaginosis in pregnancy. Cochrane Database Syst Rev (2013) 1:CD000262. doi:10.1002/14651858.CD000262.pub4
  104. Dando SJ, Nitsos I, Newnham JP, Jobe AH, Moss TJ, Knox CL. Maternal admin- istration of erythromycin fails to eradicate intrauterine ureaplasma infection in an ovine model. Biol Reprod (2010) 83:616-22. doi:10.1095/biolreprod.110. 084954
  105. Heikkinen T, Laine K, Neuvonen PJ, Ekblad U. The transplacental transfer of the macrolide antibiotics erythromycin, roxithromycin and azithromycin. BJOG (2000) 107:770-5. doi:10.1111/j.1471-0528.2000.tb13339.x
  106. Keelan JA, Nitsos I, Saito M, Musk GC, Kemp MW, Timmins M, et al. Maternal- amniotic-fetal distribution of macrolide antibiotics following intravenous, intramuscular, and intraamniotic administration in late pregnant sheep. Am J Obstet Gynecol (2011) 204(546):e510-47. doi:10.1016/j.ajog.2011.02.035
  107. Kemp MW, Miura Y, Payne MS, Watts R, Megharaj S, Jobe AH, et al. Repeated maternal intramuscular or intraamniotic erythromycin incompletely resolves intrauterine Ureaplasma parvum infection in a sheep model of pregnancy. Am J Obstet Gynecol (2014) 211:134.e1-9. doi:10.1016/j.ajog.2014.02.025
  108. Keelan JA, Kemp MW, Payne MS, Johnson D, Stock SJ, Saito M, et al. Maternal administration of solithromycin, a new, potent, broad-spectrum fluoroketolide antibiotic, achieves fetal and intra-amniotic antimicrobial protection in a pregnant sheep model. Antimicrob Agents Chemother (2014) 58:447-54. doi:10.1128/AAC.01743-13
  109. Putnam SD, Castanheira M, Moet GJ, Farrell DJ, Jones RN. CEM-101, a novel fluoroketolide: antimicrobial activity against a diverse collection of Gram-positive and Gram-negative bacteria. Diagn Microbiol Infect Dis (2010) 66:393-401. doi:10.1016/j.diagmicrobio.2009.10.013
  110. Lamont RF, Nhan-Chang CL, Sobel JD, Workowski K, Conde-Agudelo A, Romero R. Treatment of abnormal vaginal flora in early pregnancy with clin- damycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis. Am J Obstet Gynecol (2011) 205:177-90. doi:10.1016/j.ajog. 2011.03.047
  111. Hendler I, Goldenberg RL, Mercer BM, Iams JD, Meis PJ, Moawad AH, et al. The Preterm Prediction Study: association between maternal body mass index and spontaneous and indicated preterm birth. Am J Obstet Gynecol (2005) 192:882-6. doi:10.1016/j.ajog.2004.09.021
  112. Bukowski R, Malone FD, Porter FT, Nyberg DA, Comstock CH, Hankins GD, et al. Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. PLoS Med (2009) 6:e1000061. doi:10.1371/ journal.pmed.1000061
  113. De-Regil LM, Fernandez-Gaxiola AC, Dowswell T, Pena-Rosas JP. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst Rev (2010) 10:CD007950. doi:10.1002/14651858. CD007950.pub2
  114. Olsen SF, Hansen HS, Sorensen TI, Jensen B, Secher NJ, Sommer S, et al. Intake of marine fat, rich in (n-3)-polyunsaturated fatty acids, may increase birth- weight by prolonging gestation. Lancet (1986) 2:367-9. doi:10.1016/S0140- 6736(86)90055-3
  115. Carlson SE, Colombo J, Gajewski BJ, Gustafson KM, Mundy D, Yeast J, et al. DHA supplementation and pregnancy outcomes. Am J Clin Nutr (2013) 97:808-15. doi:10.3945/ajcn.112.050021
  116. Horvath A, Koletzko B, Szajewska H. Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Br J Nutr (2007) 98:253-9. doi:10.1017/ S0007114507709078
  117. Copper RL, Goldenberg RL, Das A, Elder N, Swain M, Norman G, et al. The preterm prediction study: maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Net- work. Am J Obstet Gynecol (1996) 175:1286-92. doi:10.1016/S0002-9378(96) 70042-X
  118. Challis JR, Smith SK. Fetal endocrine signals and preterm labor. Biol Neonate (2001) 79:163-7. doi:10.1159/000047085
  119. Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol (2008) 51:333-48. doi:10.1097/GRF.0b013e31816f2709
  120. Hodnett ED, Fredericks S, Weston J. Support during pregnancy for women at increased risk of low birthweight babies. Cochrane Database Syst Rev (2010) 6:CD000198. doi:10.1002/14651858.CD000198.pub2
  121. Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol (1996) 67:1103-13. doi:10.1902/jop.1996.67.10.1103
  122. Offenbacher S, Jared HL, O'Reilly PG, Wells SR, Salvi GE, Lawrence HP, et al. Potential pathogenic mechanisms of periodontitis associated pregnancy com- plications. Ann Periodontol (1998) 3:233-50. doi:10.1902/annals.1998.3.1.233
  123. Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE, et al. Treatment of periodontal disease and the risk of preterm birth. N Engl J Med (2006) 355:1885-94. doi:10.1056/NEJMoa062249
  124. Newnham JP, Newnham IA, Ball CM, Wright M, Pennell CE, Swain J, et al. Treatment of periodontal disease during pregnancy: a random- ized controlled trial. Obstet Gynecol (2009) 114:1239-48. doi:10.1097/AOG. 0b013e3181c15b40
  125. Offenbacher S, Beck JD, Jared HL, Mauriello SM, Mendoza LC, Couper DJ, et al. Effects of periodontal therapy on rate of preterm delivery: a random- ized controlled trial. Obstet Gynecol (2009) 114:551-9. doi:10.1097/AOG. 0b013e3181b1341f
  126. Jakobsson M, Gissler M, Sainio S, Paavonen J, Tapper AM. Preterm delivery after surgical treatment for cervical intraepithelial neoplasia. Obstet Gynecol (2007) 109:309-13. doi:10.1097/01.AOG.0000253239.87040.23
  127. Schiffman MH, Bauer HM, Hoover RN, Glass AG, Cadell DM, Rush BB, et al. Epidemiologic evidence showing that human papillomavirus infection causes www.frontiersin.org most cervical intraepithelial neoplasia. J Natl Cancer Inst (1993) 85:958-64. doi:10.1093/jnci/85.12.958
  128. Frazer IH. Development and implementation of papillomavirus prophylactic vaccines. J Immunol (2014) 192:4007-11. doi:10.4049/jimmunol.1490012

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