Document Detail


The epidemiology of preterm labour--why have advances not equated to reduced incidence?
MedLine Citation:
PMID:  17206958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The major burden of preterm birth is in the developing world, where most of the increasing death and morbidity is secondary to infectious diseases such as malaria, HIV, tuberculosis, bacterial vaginosis and intestinal parasites. In some developing countries, the growth of medical care has outstripped the growth of preventive public health, with an associated increase in iatrogenic preterm births. In developed countries, more than one-third of preterm births are medically indicated because of conditions such as fulminating pre-eclampsia or severe intrauterine growth restriction. Neither of these conditions is currently preventable. One in five preterm births is associated with multiple pregnancy, and these have been greatly increased by assisted reproduction techniques. The use of tocolytics has proved disappointing perhaps because inflammation rather than spontaneous uterine activity is increasingly recognised as the final common pathway. Inappropriate antibiotics used late in pregnancy are ineffective and may have adverse effects. Currently, the most promising interventions are public health related and include reducing the transmission of communicable diseases, improvements in the management of diabetes and reduction in harmful behaviours such as smoking and drug abuse.
Authors:
P J Steer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  113 Suppl 3     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-01-08     Completed Date:  2007-04-24     Revised Date:  2008-03-25    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  1-3     Citation Subset:  AIM; IM    
Affiliation:
Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Faculty of Medicine, Imperial College London, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Developed Countries / statistics & numerical data
Developing Countries / statistics & numerical data
Female
Humans
Incidence
Inflammation
Obstetric Labor, Premature / epidemiology*,  etiology
Pregnancy
Public Health
Tocolysis*
Comments/Corrections
Erratum In:
BJOG. 2008 Apr;115(5):674-5

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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