Infections and Preterm Labor

Preterm labor is a leading cause of neonatal mortality and, a significant negative impact is reported in children of less than 5 years. This problem is found both in developed and developing countries, more so in developing countries. The effect of preterm delivery may last as lifelong disability and low quality of life. The key to reduce the adverse outcomes is evaluating risk factors and interventions in all three antenatal trimesters. Any infection during pregnancy, either systemic or local, has the potential to develop preterm labor. Almost 30-40% of preterm delivery is following infection. The majority of times, it is through ascending cervicovaginal infection leading to intra-amniotic infection. Signals arising from microorganisms essentially activate the labor pathway prematurely by inflammatory cytokines, chemokines, proteases, and prostaglandin release. The primary prevention is by appropriate education to maintain good hygiene and nutrition. Risk reduction strategy includes a screening of pregnancy for infection and appropriate antibiotic treatment. In a woman with inevitable preterm delivery, the most beneficial maternal intervention is steroids with/without short-term tocolysis and neuroprotective agents. This treatment improves survival chances and health outcomes in preterm babies.