Those of us in the obstetrics community have long been searching for an effective treatment for preterm birth, an affliction that affects 10% of all births in the US and has not shown a decline in rates for the past decade.1,2 Preterm birth is associated with perinatal mortality and morbidity of surviving neonates, accounting for the biggest contributing factor for both. This comes at a significant emotional and financial cost to both society and the individual families involved. While effective treatments have been elusive and some interventions proven ineffective, there is a wide repository of research documenting risk factors for preterm birth.3 The hope of this research is to find modifiable risk factors that could potentially lead to interventions resulting in lower rates of preterm birth.
Rosa et al, in their recent study entitled “Association of patient characteristics with preterm birth among patients with a history of preterm birth: a single-center retrospective study” in this issue of Baylor University Medical Center Proceedings, went searching for both.4 They hypothesized that cervical length screening could potentially identify women at higher risk for preterm birth among patients with a history of preterm birth. They also looked at other characteristics of their patient population with a prior preterm birth to assess for increased risk for preterm birth in the subsequent pregnancy. Their findings showed that patients who had cervical length screening were at increased risk of preterm birth, the antithesis to their hypothesis. However, when taken contextually, this finding can be explained by the fact that those who were screened were already at increased risk of delivering preterm, and unfortunately, as stated before, we as a medical specialty do not have a clear treatment to prevent preterm birth. If the trouble we go looking for is preterm birth, in most cases that is what we will find.
—Shena Dillon, MD
Department of Obstetrics and Gynecology, Baylor All Saints Medical Center, Fort Worth, Texas, USA
Shena.Dillon@BSWHealth.org
http://orcid.org/0000-0003-4350-0585
References
- 1.Meis PJ, Klebanoff M, Thom E, et al. ; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network . Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med. 2003;348(24):2379–2385. Erratum in: N Engl J Med. 2003;349(13):1299. Erratum in: N Engl J Med. 2024;391(2):192. doi: 10.1056/NEJMoa035140. [DOI] [PubMed] [Google Scholar]
- 2. Prediction and prevention of spontaneous preterm birth: ACOG practice bulletin summary, number 234. Obstet Gynecol. 2021;138(2):320–323. doi: 10.1097/AOG.0000000000004480. [DOI] [PubMed] [Google Scholar]
- 3.Blackwell SC, Gyamfi-Bannerman C, Biggio JR Jr, et al. 17-OHPC to Prevent Recurrent Preterm Birth in Singleton Gestations (PROLONG Study): a multicenter, international, randomized double-blind trial. Am J Perinatol. 2020;37(2):127–136. doi: 10.1055/s-0039-3400227. [DOI] [PubMed] [Google Scholar]
- 4.Rosa MN, Villazana-Kretzer D, Hofkamp MP.. Association of patient characteristics with preterm birth among patients with a history of preterm birth: a single-center retrospective study. Proc (Bayl Univ Med Cent). 2026;38(6):1070–1074. doi: 10.1080/08998280.2026.2697683. [DOI] [PMC free article] [PubMed] [Google Scholar]