A Comprehensive Update on the Management of Preterm Labor: A Narrative Review

Abstract

Preterm labor (PTL) is defined as any birth before 37 completed weeks of gestation, or fewer than 259 days since the first day of the woman's last menstrual period (LMP). It is further classified into extremely preterm (less than 28 weeks), very preterm (28 to less than 32 weeks), and moderate or late preterm (32 to less than 37 completed weeks of gestation) based on the gestational age. PTL is associated with significant neonatal morbidity and mortality and maternal morbidity. Hence, it is essential to understand the risk factors associated with it and intervene in a timely manner to prevent or reduce the adverse perinatal outcomes. Obstetric factors, unmodifiable gynecological factors, chronic medical conditions, and recurrent periodontal disease predispose to PTL. Spontaneous PTL is mostly attributed to ascending genital tract infections during pregnancy. Maternal stress during pregnancy alters the neuroendocrine system and exaggerates the inflammatory responses and vascular hemodynamics predisposing to PTL. This narrative review has tried to summarize the various existing guidelines regarding the management (both prophylactic and therapeutic) of PTL.