Preterm birth Risk factors and treatment

Preterm birth, defined as a delivery before 37 completed weeks of gestation, is a major cause of neonatal mortality and morbidity worldwide. The pathogenesis of preterm birth is complex and largely unknown, and understanding of risk factors remains poor. Ideally, identification of risk factors will lead to effective interventions that reduce or prevent preterm birth. The first part of this thesis studies population trends in the Netherlands and studies risk factors for preterm birth.
Once clinical symptoms of threatened preterm birth occur at a viable gestational age, it is challenging to prevent preterm birth. Treatment is then aimed at safe delivery and improvement of neonatal outcome. The second part of this thesis focuses on improving neonatal and long-term outcomes in threatened preterm birth, specifically the effectiveness of tocolysis (inhibiting labor). We state that, although tocolytics are widely used, there is currently no evidence to routinely administer tocolytics in threatenend preterm birth.