Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth

Lancet. 2008 Jan 12;371(9607):164-75. doi: 10.1016/S0140-6736(08)60108-7.


Interventions to reduce the morbidity and mortality of preterm birth can be primary (directed to all women), secondary (aimed at eliminating or reducing existing risk), or tertiary (intended to improve outcomes for preterm infants). Most efforts so far have been tertiary interventions, such as regionalised care, and treatment with antenatal corticosteroids, tocolytic agents, and antibiotics. These measures have reduced perinatal morbidity and mortality, but the incidence of preterm birth is increasing. Advances in primary and secondary care, following strategies used for other complex health problems, such as cervical cancer, will be needed to prevent prematurity-related illness in infants and children.

Publication types

  • Review

MeSH terms

  • Female
  • Health Policy
  • Humans
  • Infant, Newborn
  • Perinatal Care / methods
  • Pregnancy
  • Premature Birth* / epidemiology
  • Premature Birth* / mortality
  • Premature Birth* / prevention & control
  • Prenatal Care*
  • Prenatal Nutritional Physiological Phenomena
  • Risk Factors
  • Tocolytic Agents / therapeutic use*


  • Tocolytic Agents