MODERN APPROACHES TO THE PREVENTION OF PRETERM BIRTH: A LITERATURE REVIEW

Abstract

Preterm birth remains one of the most important challenges in modern obstetrics and neonatology, as it is a leading cause of perinatal morbidity, mortality, and long-term adverse health outcomes in children. Millions of infants are born prematurely worldwide each year, and complications associated with prematurity significantly increase the risk of respiratory, neurological, metabolic, and cardiovascular disorders both during the early neonatal period and later in life. Despite substantial advances in perinatal medicine, the incidence of preterm birth remains high, highlighting the need for improved methods of risk prediction and prevention.

The aim of this review was to analyze current literature regarding risk factors, pathophysiological mechanisms, screening methods, and contemporary strategies for the prevention of preterm birth, with a particular focus on personalized approaches to the management of high-risk pregnancies. The review summarizes findings from recent clinical studies, systematic reviews, and meta-analyses evaluating the predictive value of transvaginal cervical length measurement, fetal fibronectin testing, as well as the effectiveness of vaginal progesterone, cervical cerclage, and combined preventive interventions.

The analysis indicates that preterm birth is a multifactorial syndrome in which infectious and inflammatory processes, cervical insufficiency, multiple pregnancy, endocrine disorders, and behavioral risk factors play significant roles. The most effective preventive strategy involves the timely identification of women at high risk through the use of modern screening methods and individualized selection of preventive measures. Vaginal progesterone and cervical cerclage remain the most evidence-based approaches for preventing preterm birth, while combined strategies have demonstrated promising results in high-risk patients.

Therefore, the contemporary concept of preterm birth prevention is based on the principles of personalized medicine, including comprehensive risk assessment, early screening, and the implementation of individually tailored preventive strategies. Further development of innovative diagnostic technologies and novel therapeutic approaches may contribute to reducing the incidence of preterm birth and improving perinatal outcomes.

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