Prevention of spontaneous preterm birth

  • George Daskalakis
  • Maria Goya
  • Vasilios Pergialiotis
  • Luis Cabero
  • Ioannis KyvernitakisEmail author
  • Aris Antsaklis
  • Birgit Arabin
Maternal-Fetal Medicine



It is estimated that globally, approximately 13 million preterm infants are born annually and a much higher number of pregnancies are characterized by threatening preterm birth.


A proportional inverse correlation between gestational age at delivery and neonatal mortality has been observed which is more prevalent in countries without high standard neonatal care. The socioeconomic burden of preterm birth is enormous, as preterm neonates are particularly prone to severe morbidity that may expand up to adulthood. Several strategies have been proposed for the prevention of preterm birth which can be sub-stratified as primary (when these apply to the general population), secondary (when they target women at risk), and tertiary (optimizing neonatal outcomes when preterm birth cannot any longer be prevented). The aim of this review is to summarize the most important strategies.


Preterm birth Prevention Progesterone Cerclage Pessary Smoking Pregnancy 


Author contributions

GD: project development. MG: manuscript writing. VP: manuscript writing. LC: project development. IK: data collection, manuscript writing and revising. AA: project development. BA: manuscript writing and revising.


The authors did not receive funding for the present work.

Compliance with ethical standards

Conflict of interest

Birgit Arabin has a direct ownership interest in a company that designed, produces and now distributes the Arabin pessary. The company is privately held and the profit is used to support the Clara Angela Foundation. The remaining authors report no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Maternal-Fetal Medicine Unit, First Department of Obstetrics and GynecologyNational and Kapodistrian University of Athens, Alexandra Maternity Hospital AthensAthensGreece
  2. 2.High-Risk Pregnancy Unit, Department of Obstetrics and Gynaecology, Preterm Birth Prevention Clinic, Maternal-Foetal Medicine, Hospital Universitari Vall D’Hebron, Vall D’Hebron Research Institute (VHIR)UniversitatAutònoma de Barcelona (UAB)BarcelonaSpain
  3. 3.Laboratory of Experimental Surgery and Surgical Research N.S ChristeasNational and Kapodistrian University of AthensAthensGreece
  4. 4.Depatment of Obstetrics and Gynecology, Centre for Ultrasound and Prenatal Medicine, Buergerhospital and Clementine Childern’S Hospital Frankfurt a.MDr. Senckenberg Foundation and Goethe-University of FrankfurtFrankfurt/MainGermany
  5. 5.Clara Angela Foundation Center for Research and DevelopmentWittenGermany
  6. 6.Department of Obstetrics ChariteHumboldt University BerlinBerlinGermany

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