Table 2 Types of Preterm Birth and Risk Factors
From: Born Too Soon: The global epidemiology of 15 million preterm births
Type: | Risk Factors: | Examples: | Interventions:* |
|---|---|---|---|
Spontaneous preterm birth: | Age at pregnancy and pregnancy spacing | Adolescent pregnancy, advanced maternal age, or short inter-pregnancy interval | Preconception care, including encouraging family planning beginning in adolescence and continuing between pregnancies |
| Â | Multiple pregnancy | Increased rates of twin and higher order pregnancies with assisted reproduction | Introduction and monitoring of policies for best practice in assisted reproduction |
| Â | Infection | Urinary tract infections, asymptomatic bactiuria, malaria, HIV, syphilis, chorioamnionitis, bacterial vaginosis | Sexual health programs aimed at prevention and treatment of infections prior to pregnancy. Specific interventions to prevent infections and mechanisms for early detection and treatment of infections occurring during pregnancy. |
| Â | Underlying maternal chronic medical conditions | Diabetes, hypertension, anaemia, asthma, thyroid disease | Improve control prior to conception and throughout pregnancy |
| Â | Nutritional | Undernutrition, micronutrient deficiencies | |
| Â | Lifestyle/work related | Smoking, excess alcohol consumption, recreational drug use, excess physical work/activity | Behavior and community interventions targeting all women of childbearing age in general and for pregnant women in particular through antenatal care with early detection and treatment of pregnancy complications |
| Â | Maternal psychological health | Depression, violence against women | |
| Â | Genetic and other | Genetic risk, e.g., family history Cervical incompetence Intra-uterine growth restriction Congenital abnormality | |
Provider-initiated preterm birth: | Medical induction or cesarean birth for: | Prior classical cesarean section, Placenta accrete. | In addition to the above: Programs and policies to reduce the practice of non-medically indicated induction of labor or cesarean birth |
| Â | obstetric indication Fetal indication Other - Not medically indicated | There is an overlap for indicated provider-initiated preterm birth with the risk factors for spontaneous preterm birth | Â |