Pre-Term Birth

The leading cause of perinatal morbidity and death and the rate of pre-term birth has not decreased over the past 20 years.

Rate is about 10%.

It is the most important cause of morbidity and mortality in children younger than five years.

It is an important risk factor for psychiatric, metabolic, cardiovascular and renal disease later in life.

Evidence exists that being born in the late preterm period, between 34 and 36 weeks gestation is associated with long-term adverse effects.

For infants born before 28 weeks of gestation there are one more major impairments including cerebral palsy, intellectual disability, deafness, or blindness in approximately 40% of infants.

Adverse outcomes include cerebral palsy, increased hospital admissions in early childhood, lower childhood height, asthma, long-term illnesses, and poorer educational attainment.

Preterm infants have increased susceptibility to infection due to decreased transfer of protective maternal antibodies and possibly due to the relative immaturity of the immune system.
Among preterm infants come administration of scheduled vaccinations during the first year is associated with protective antibody levels against most antigens, except for Haemophilus influenzae type B.

Long-term follow-up studies show a higher risk of behavioral disorders such as attention deficit disorder, autism, and psychiatric disorders among children born preterm that

than among those born at term.

An estimated 4-5% of infants are born at 34-36 weeks, and 30% of preterm births follow premature rupture of the membranes.

Subclinical hypothyroidism, and anti-thyroid peroxidase antibody levels in pregnant women are risk factors for preterm birth.

Cannabis use is associated with a 12% preterm birth rate, while it is is 6.1% among non-users.

The PROLONG study found that hydroxyprogesterone caproate was no more effective than a placebo in preventing preterm birth (Rubin R).

Maternal antenatal corticosteroid treatment to accelerate fetal maturation is standard care before 34 weeks gestation when there is a risk of delivery within seven days.


In infants born before 34 weeks corticosteroids reduces the risk of respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, need for mechanical ventilation, systemic infections, and death.


In a study of 670,097  children exposed to maternal antenatal corticosteroid treatment was associated with significant mental and behavioral disorders in children (Raikkonen K).

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