Improving identification and treatment of women with increased risk of preterm birth

Preterm birth is one of the major global health problems. It is globally defined as birth before 37 weeks of gestation. Annually 15 million babies are born preterm worldwide, with an incidence rate varying between five and fifteen percent. Preterm birth and its associated complications are held responsible for 1 million deaths annually amongst children under the age of 5 years. Sequelae of preterm birth affect childhood and adolescents’ health in term of neuro-developmental disorders, behavioural disorders and chronic diseases. Preterm birth not only influences the children but also has an impact on parents and society, and it is associated with healthcare costs up to billions.
Prevention of preterm birth is one of the main tasks for obstetricians and researchers working in the obstetrical field. Keystones for adequate prevention of preterm birth are effective identification (prediction and diagnosing) and treatment of women with an increased risk of preterm birth. Due to the heterogeneity of preterm birth there are several caveats concerning the identification and treatment of women with an increased risk of preterm birth. Thus we need further improvement of both to improve the prevention of preterm birth.
The objective of this thesis was to improve the prevention of preterm birth by reaching back to the keystones; identification and treatment of women at risk of preterm birth. The aims of the studies incorporated in this thesis are twofold. Part 1, addresses several research questions to improve the identification of women at risk of preterm birth; Part 2 addresses several research questions to improve treatment of women with an increased risk of preterm birth.