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Lancet. 2008 Jan 12;371(9607):164-75.
Primary, secondary, and tertiary interventions to reduce
the morbidity and mortality of preterm birth.
Iams JD, Romero R, Culhane JF, Goldenberg RL.
Department of Obstetrics and Gynecology, Ohio State
University, Columbus, OH, USA. iams.1@osu.edu
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.
   
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