Abstract
Women with a prior preterm birth are at increased risk of recurrent preterm delivery
in a subsequent pregnancy. Interventions during the preconception and prenatal periods
can decrease this risk. Review of the circumstances of the prior delivery can elucidate
whether delivery was spontaneous or indicated, anticipate recurrence risk, and guide
management in a subsequent pregnancy. Preconception interventions for women with prior
preterm birth should include cessation of tobacco and substance abuse, control of
underlying maternal comorbidities, and encouraging a healthy body mass index. Effective
contraception, including use of long-acting reversible methods, should be encouraged
to facilitate planned pregnancies with optimal interpregnancy intervals. Interventions
during prenatal care include screening and treatment of infections, nutritional supplementation,
and enhanced prenatal care. Women with prior spontaneous preterm birth may benefit
from progesterone supplementation and serial cervical length screening, while women
with prior indicated preterm birth may benefit from daily aspirin.
Keywords
preterm birth - preconception care - prenatal care - interpregnancy interval
