Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2008 Jan 5;371(9606):75-84.
doi: 10.1016/S0140-6736(08)60074-4.

Epidemiology and causes of preterm birth

Robert L Goldenberg  1 , Jennifer F Culhane, Jay D Iams, Roberto Romero
Affiliations
Review

Epidemiology and causes of preterm birth

Robert L Goldenberg et al. Lancet. .

Abstract

This paper is the first in a three-part series on preterm birth, which is the leading cause of perinatal morbidity and mortality in developed countries. Infants are born preterm at less than 37 weeks' gestational age after: (1) spontaneous labour with intact membranes, (2) preterm premature rupture of the membranes (PPROM), and (3) labour induction or caesarean delivery for maternal or fetal indications. The frequency of preterm births is about 12-13% in the USA and 5-9% in many other developed countries; however, the rate of preterm birth has increased in many locations, predominantly because of increasing indicated preterm births and preterm delivery of artificially conceived multiple pregnancies. Common reasons for indicated preterm births include pre-eclampsia or eclampsia, and intrauterine growth restriction. Births that follow spontaneous preterm labour and PPROM-together called spontaneous preterm births-are regarded as a syndrome resulting from multiple causes, including infection or inflammation, vascular disease, and uterine overdistension. Risk factors for spontaneous preterm births include a previous preterm birth, black race, periodontal disease, and low maternal body-mass index. A short cervical length and a raised cervical-vaginal fetal fibronectin concentration are the strongest predictors of spontaneous preterm birth.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Percentage of all births classified as preterm in the USA, 1981–2004 Source: Martin JA, Kochanek KD, Strobino DM, Guyer B, MacDorman MF. Annual summary of vital statistics—2003. Pediatrics 2005; 115: 619–34.
Figure 2
Figure 2
Obstetric precursors of preterm birth
Figure 3
Figure 3
Temporal changes in singleton preterm births overall and temporal changes resulting from ruptured membranes, medically indicated preterm labour, and spontaneous preterm labour in USA, 1989–2000 A) Rates in each group by year. B) The percentage change in rates relative to 1989. Figure adapted from reference 9.
Figure 4
Figure 4
Comparison of spontaneous and indicated preterm birth by maternal body-mass index (BMI) Figure adapted from reference 35.
Figure 5
Figure 5
Potential routes of intrauterine infection
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Slattery MM, Morrison JJ. Preterm delivery. Lancet. 2002;360:1489–1497. - PubMed
    1. Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2005. Health E-Stats. Hyattsville, MD, 2006. http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimbirths05/prelim... (accessed July 15, 2007). - PubMed
    1. Goldenberg RL, Rouse DJ. The prevention of premature birth. N Engl J Med. 1998;339:313–320. - PubMed
    1. Iams JD, Romero R, Culhane JF, Goldenberg RL. The prevention of preterm birth. Lancet (in press).
    1. McCormick MC. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med. 1985;312:82–90. - PubMed