The review reports on risk factors and the prevention of preterm birth based on an international literature review from 2000 to 2019 (1). The following shortcomings can be noted:
The development of preterm birth rates in Germany is shown based on a comparison of the years 2009 and 2017, such that a temporal trend cannot be recognized.
This two-year comparison is incorrect, because preterm birth rates (2009) are compared with rates of babies born preterm (2017).
The overview of the risk factors is incomplete. Among other things, the missing factors include body mass index, diabetes mellitus, gestational diabetes, iron deficiency without anemia, hypertension, thyroid dysfunction, psychological stress, the use of illicit drugs, weight gain during pregnancy, advanced maternal age, and ethnic origin (2).
It is particularly critical that the article gives the risk measures (odds ratio [OR], relative risk [RR]) but not the prevalence of these risk factors among pregnant women in Germany, which is however critical for the preventive potential. Research on the prevalence would have revealed considerable deficits in the epidemiological data regarding the living conditions and behaviors of pregnant women as well as research needs. However, the dataset of the BabyCare program, with over 60000 cases, could have been used as an approximation.
The article states that rates of preterm births have not been reduced in many countries. Are the authors not aware of the drastic reduction in preterm birth rates in the United States since 2007 (3)?
As a conclusion, the authors note that a careful assessment of t he risk factors should be carried out at the beginning of pregnancy. Practicing gynecologists have done this for decades. What is the new message?
Footnotes
Conflict of interest statement
The author‘s wife is the managing director of FBE GmbH. Dr. Kirschner has received reimbursement for travel expenses by FBE GmbH and receives a salary from FBE GmbH as scientific director.
References
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