Preterm Parturition And Pre-Eclampsia: The Confluence Of Two Great Gestational Syndromes

Background Preterm birth (PTB) and pre-eclampsia independently, and frequently concurrently, adversely affect the pregnancy outcomes of millions of mothers and infants worldwide each year. Objectives To fill the gap betweenPTBand pre-eclampsia, which continue to constitute the two most important current global challenges to maternal and perinatal health. Methods Pubmed, Embase, and Cochrane databases were searched from inception until December 2019 using the terms spontaneousPTB(SPTB), indicated preterm delivery (IPTD), early-onset pre-eclampsia, and pre-eclampsia. Results History ofPTBand pre-eclampsia were the strongest risk factors contributing to the occurrence ofSPTBorIPTB. The risk ofPTBand pre-eclampsia among non-Hispanic African American women was higher than the rate among all other racial/ethnic groups in the United States. Low-dose aspirin (LDA) has been reported to reduce the risk of pre-eclampsia by at least 10% andPTBby at least 14%. Lastly, women and their fetuses who develop early-onset pre-eclampsia are at higher risk for developing hypertension and cardiovascular disease later in life. Conclusions While better clarity is needed, efforts to coordinate prevention of bothPTBand pre-eclampsia, even though imperfect, are critically important as part of any program to make motherhood as safe as possible.