Introduction
Preterm labor refers to the onset of uterine contractions of
sufficient strength and frequency to effect progressive
dilatation and effacement of cervix between 20 and 37 weeks
of gestation. Preterm labor complicates 5-10% of pregnancies
and is a leading cause of neonatal morbidity and mortality
worldwide. It is a major public health problem in terms of
loss of life, long-term disability (cerebral palsy, blindness,
deafness, chronic lung disease) and health care costs both in
the developing and the developed world. In the USA,
approximately 450,000 (11.5%) preterm births occur annually,
directly contributing to 75% of neonatal mortality and 50%
of long-term neurological impairment in children. Moreover,
it accounts for 35% and 10% of healthcare spending for
infants and children, respectively. Many developing countries
are unable to cope with the healthcare costs associated with
managing neonates that are born preterm, resulting in higher
and often unacceptable neonatal morbidity and mortality.
Unfortunately, the incidence of preterm labor has changed
very little over the last 40 years and uncertainties still persist
regarding the best strategies for its management. It has been
widely recognised that its prevention and/or effective
management will improve neonatal outcome and will have a
profound impact on societal and long-term public healthcare
costs. In this article we review the epidemiology and recent
advances in prediction, prevention and management of preterm
labor
IntroductionPreterm labor refers to the onset of uterine contractions ofsufficient strength and frequency to effect progressivedilatation and effacement of cervix between 20 and 37 weeksof gestation. Preterm labor complicates 5-10% of pregnanciesand is a leading cause of neonatal morbidity and mortalityworldwide. It is a major public health problem in terms ofloss of life, long-term disability (cerebral palsy, blindness,deafness, chronic lung disease) and health care costs both inthe developing and the developed world. In the USA,approximately 450,000 (11.5%) preterm births occur annually,directly contributing to 75% of neonatal mortality and 50%of long-term neurological impairment in children. Moreover,it accounts for 35% and 10% of healthcare spending forinfants and children, respectively. Many developing countriesare unable to cope with the healthcare costs associated withmanaging neonates that are born preterm, resulting in higherand often unacceptable neonatal morbidity and mortality.Unfortunately, the incidence of preterm labor has changedvery little over the last 40 years and uncertainties still persistregarding the best strategies for its management. It has beenwidely recognised that its prevention and/or effectivemanagement will improve neonatal outcome and will have aprofound impact on societal and long-term public healthcarecosts. In this article we review the epidemiology and recentadvances in prediction, prevention and management of pretermlabor
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