Preterm delivery

Preterm delivery and its short-term and long-term sequelae constitute a serious problem in terms of mortality, disability, and cost to society. The incidence of preterm delivery, which has increased in recent years, is associated with various epidemiological and clinical risk factors. Results of randomised controlled trials suggest that attempts to reduce these risk factors by use of drugs are limited by side-effects and poor efficacy. An improved understanding of the physiological pathways that regulate uterine contraction and relaxation in animals and people has, however, helped to define the complex processes that underlie parturition (term and preterm), and has led to new scientific approaches for myometrial modulation. The continuing elucidation of the mechanisms that regulate preterm labour, combined with rigorous clinical assessment, offer hope for future solutions.