Prognosis

Risk of recurrence of spontaneous premature labour and birth are well defined, and remarkably consistent in spite of the varied aetiology. Only if women have recurrent preterm births at early gestations do they tend to have a future risk of >50%.[17]​ Even in women who have major risk factors, such as extensive cervical surgery, it is rare not to achieve a viable pregnancy with appropriate management. These patients may be more amenable to intervention such as cervical cerclage.

Studies suggest women who deliver preterm may have an increased risk of all-cause and disease-specific premature mortality later in life, but the mechanisms are unclear.[156][157][158]​​​ In one large national cohort study in Sweden, the risk was higher for medically-indicated versus spontaneous preterm delivery (adjusted hazard ratios 1.70 [95% CI 1.52 to 1.90] and 1.21 [95% CI 1.08 to 1.35], respectively) and multiple preterm deliveries further increased mortality risk.[156]

Gestational age at delivery is key to the mortality and morbidity of the fetus. At gestations under 26 weeks, overt neurological damage occurs in about 1 in 4 babies, resulting in morbidities such as cerebral palsy, blindness, or deafness.[159]​ Severe disability occurs in about 1 in 10 babies at 26 weeks’ gestation, and about 1 in 3 babies at 22 weeks’ gestation.[1]

Use of this content is subject to our disclaimer