Predictors and risk factors of spontaneous premature birth: Аnamnestic characteristics, ultrasound, and biomarkers (a literature review)
DOI:
https://doi.org/10.37800/RM.3.2023.63-71Keywords:
spontaneous premature birth, predictors of premature birth, risk factors for premature birthAbstract
Relevance: Premature birth (PB) is the leading health problem worldwide and is currently considered the leading cause of newborn mortality. Approximately 15 million babies are born prematurely yearly, accounting for about 11% of all births worldwide. Since the PB etiology remains unclear, identifying risk factors and determining individual risk is important in managing pregnant women. Despite significant efforts to reduce the incidence of spontaneous premature birth (SPB), they remain the leading cause of perinatal morbidity and mortality. The existing screening strategies are not perfect.
The study aimed to examine and analyze current data on risk factors and predictors of premature birth for predicting premature birth.
Materials and Methods: The review covered data on SPB risk factors and predictors over the past decade published in Medline, Scopus, Web of Science, Google Scholar, PubMed, Willey, and the Cochrane Library. The search utilized such keywords as “spontaneous premature birth,” “predictors of premature birth,” and “risk factors for premature birth” using MeSH.
Results: Of all the known factors, a history of birth control and miscarriage are the leading risk factors for SPB. Cervicometry, or measuring the length of the cervix during ultrasound examination, is a common and fairly effective method for predicting SPB. Fetal fibronectin is one of the common markers for predicting PB. In addition to cervical factors, maternal serum markers have also been proposed for predicting PB.
Conclusion: Identifying SPB risk factors is an important component of obstetric care, as early intervention can effectively reduce the risk of SPB. There is no single or combined screening method for PB sensitive enough to identify women at risk of PB and specific enough to prevent unnecessary interventions and high treatment costs. Cervicometry is the most economical method used in clinical practice. Studies on metabolomics, proteomics, and microRNA profiling have brought a new dimension to this topic. Perhaps in the future, with a clear identification of women at true risk of PB, more effective preventive strategies will be developed.
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