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Am J Perinatol 2016; 33(03): 267-275
DOI: 10.1055/s-0035-1571143
Prematurity Special Issue
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Optimizing Subsequent Pregnancy Outcomes for Women with a Prior Preterm Birth

Laura C. Colicchia
1   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Hyagriv N. Simhan
1   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
› Author Affiliations
Further Information

Publication History

18 November 2015

24 November 2015

Publication Date:
25 January 2016 (online)

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Abstract

Women with a prior preterm birth are at increased risk of recurrent preterm delivery in a subsequent pregnancy. Interventions during the preconception and prenatal periods can decrease this risk. Review of the circumstances of the prior delivery can elucidate whether delivery was spontaneous or indicated, anticipate recurrence risk, and guide management in a subsequent pregnancy. Preconception interventions for women with prior preterm birth should include cessation of tobacco and substance abuse, control of underlying maternal comorbidities, and encouraging a healthy body mass index. Effective contraception, including use of long-acting reversible methods, should be encouraged to facilitate planned pregnancies with optimal interpregnancy intervals. Interventions during prenatal care include screening and treatment of infections, nutritional supplementation, and enhanced prenatal care. Women with prior spontaneous preterm birth may benefit from progesterone supplementation and serial cervical length screening, while women with prior indicated preterm birth may benefit from daily aspirin.

Keywords

preterm birth - preconception care - prenatal care - interpregnancy interval
 

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