Introduction to preterm labour

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Preterm delivery, defined as delivery before 37 weeks of completed gestation (259 days), is a major cause of neonatal morbidity and mortality. Despite extensive research, preterm birth still accounts for 5–10% of all deliveries in developed countries and rates are on the increase, including in the UK.

In the UK about 8% of live born babies are born preterm (less than 37 weeks of gestation). Whereas most of these are born after 28 weeks, about 0.6% are born extremely preterm (22–28 weeks). It is also noteworthy that nearly 53% of the liveborn multiple births were born preterm (less than 37 weeks).

While mortality associated with preterm delivery has declined due to use of antenatal steroids and improvements in neonatal intensive care, for example surfactant use, preterm babies remain at risk of major complications. These include respiratory distress syndrome, necrotising enterocolitis, retinopathy of prematurity, sepsis, intraventricular haemorrhage, periventricular leucomalacia and long-term cognitive and sensory impairment. Two major determinants for mortality of babies born preterm are gestation at delivery and birthweight. Preterm birth carries significant cost implications to both healthcare services and society in general.

Preterm birth has a multifactorial aetiology. Approximately 75% of deliveries occur as a result of spontaneous preterm labour, while the remainder follow intervention for maternal or fetal disorders that place the mother or fetus at risk, such as pre-eclampsia, fetal growth restriction, maternal diabetes and placenta praevia or abruption.

Last updated:12/03/12 (tutorial reviewed and updated by N Deole)

27/08/09 (BJOG paper added in the 'Prediction of preterm labour' section)

01/04/09 (research paper added in the 'Preliminary reading' and 'The clinical problem' sections).