Determinants of prematurity

Abstract

The Prematurity, due to its persistent frequency and to the high risk of neonatal morbidity and mortality associated, is still one of the biggest challenges of Perinatology and of the population programs aimed at reducing child mortality worldwide. In 2010, it was estimated that 11.1% of live births were premature in the world, that means about 15 million children. It was also very signifi cant the verifi cation that this proportion was increasing over time in many countries and it was the leading cause of neonatal mortality and the second cause of infant mortality. A preterm newborn at birth is already at high risk to develop complications related to its level of immaturity, with long-term effects, especially on its neurodevelopment. Despite the improvement observed in perinatal care over time, control of prematurity still seems distant, even in developed countries. For this reason, it is necessary to identify the most frequent determinants of prematurity in each population/country so that control programs of these can become more effi cient. In this text, the main risk factors associated with prematurity will be discussed, from those related to spontaneous preterm birth to the so-called induced or initiated premature births, with emphasis on the contribution of cesarean delivery.