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State of the Art: Updates in Preterm Labor and Preterm...
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State of the Art: Updates in Preterm Labor and Preterm Birth

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 10 December 2025 | Viewed by 2604

Special Issue Editors

Dr. Eran Bornstein

E-Mail Website
Guest Editor
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Lenox Hill Hospital—Northwell Health/Zucker School of Medicine, New York, NY 10075, USA
Interests: prenatal diagnosis; fetal neurosonography; detection of fetal anomalies in the first trimester; preterm birth
Dr. Moti Gulersen

E-Mail Website
Guest Editor
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA
Interests: preterm birth; antenatal corticosteroids; cerclage; mutiple gestations

Special Issue Information

Dear Colleagues,

Preterm birth remains a major challenge in modern obstetrics. Neonatal prematurity is a leading cause of neonatal morbidity and mortality and is associated with short and long-term complications, prolonged hospital stays, and a major financial burden on the health system. The result of premature birth has a wide, heterogeneous range of etiologies with several conditions leading to both spontaneous preterm birth and indicated iatrogenic preterm birth due to maternal or fetal conditions. Much research has been conducted to determine risk factors predisposing patients to these conditions, screening methodologies, and interventions that may help prevent preterm birth. This Special Issue aims to provide updates and new research in any of the aspects related to preterm birth, including, but not limited to, risk factors, demographic and baseline characteristics associated with at-risk patients, racial disparity in the risk or outcomes, screening methods, potential interventions or preventions strategies to reduce spontaneous or iatrogenic preterm birth and more.

Dr. Eran Bornstein
Dr. Moti Gulersen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prenatal diagnosis
  • preterm birth
  • antenatal corticosteroids
  • cerclage
  • multiple gestations

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Published Papers (3 papers)

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Research

15 pages, 691 KiB  
Article
Extreme Preterm Delivery Between 24+0 and 27+6 Weeks: Factors Affecting Perinatal Outcome
by Joanna Kowalczyk-Buss, Eleftheria Demertzidou, Sara El-Toukhy, Ghada Ramadan and Ranjit Akolekar
J. Clin. Med. 2025, 14(4), 1064; https://doi.org/10.3390/jcm14041064 - 7 Feb 2025
Viewed by 762
Abstract
Objectives: The aim of this study was to investigate the factors associated with the prediction of perinatal survival in pregnancies with extreme preterm delivery between 24+0 and 27+6 weeks’ gestation. Methods: This screening cohort study was undertaken at a large tertiary [...] Read more.
Objectives: The aim of this study was to investigate the factors associated with the prediction of perinatal survival in pregnancies with extreme preterm delivery between 24+0 and 27+6 weeks’ gestation. Methods: This screening cohort study was undertaken at a large tertiary obstetric and neonatal unit in the United Kingdom. We included singleton pregnancies that booked and delivered at our hospital. Logistic regression analysis was carried out to determine risks of complications in pregnancies delivering preterm after adjusting for maternal and pregnancy characteristics. Effect sizes were expressed as absolute risks (ARs) and odds ratios (ORs) (95% confidence intervals [CI]). Results: The study population included 53,649 singleton pregnancies, including 139 (0.3%) with preterm delivery between 24+0 and 27+6 weeks and 47,006 (99.7%) with term delivery ≥37 weeks. Multivariate regression analysis demonstrated that there was a significant contribution of uterine artery pulsatility index (UtA-PI) and cervical length, but not of maternal factors, in the prediction of preterm delivery <28 weeks. The risk of neonatal death and intact neurological survival in pregnancies delivering <28 weeks was 11.5% and 79.1%, respectively. Caesarean compared to vaginal delivery and female compared to male neonates were associated with a lower incidence of neurological morbidity (6.1% vs. 19.3%; p = 0.016 and 13.1% vs. 26.9%; p = 0.036, respectively). In the prediction of intact perinatal survival, the only significant variable was gestational age at delivery, with survival rates of about 50%, 65%, 80% and 90% at 24, 25, 26 and 27 weeks, respectively. Conclusions: In pregnancies with extreme preterm delivery between 24+0 and 27+6 weeks, caesarean compared to vaginal delivery and female compared to male neonates are associated with a lower incidence of neurological morbidity. The only significant factor in the prediction of intact perinatal survival is gestational age at delivery. Full article
(This article belongs to the Special Issue State of the Art: Updates in Preterm Labor and Preterm Birth)
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12 pages, 1183 KiB  
Article
Social Vulnerability and Pregnancy Option Counseling in the Setting of Periviable Delivery
by Gillian Piltch, Lizelle Comfort, David Krantz, Frank Jackson, Matthew J. Blitz and Burton Rochelson
J. Clin. Med. 2025, 14(2), 466; https://doi.org/10.3390/jcm14020466 - 13 Jan 2025
Viewed by 685
Abstract
Background/Objectives: According to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, pregnant people facing periviable delivery should be counseled on expected neonatal outcomes and available pregnancy options. The objective of this study is to evaluate if rates [...] Read more.
Background/Objectives: According to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, pregnant people facing periviable delivery should be counseled on expected neonatal outcomes and available pregnancy options. The objective of this study is to evaluate if rates of neonatology consultation and pregnancy option counseling for those facing periviable delivery differ based on social vulnerability factors or Social Vulnerability Index (SVI). Methods: This was a retrospective cohort study of patients who delivered at 22 0/7 weeks to 25 6/7 weeks of gestation at two academic medical centers with level III or IV neonatal intensive care units from 2019 to 2022. We analyzed the association between individual-level social vulnerability factors and census-tract-level SVI (released by the Center for Disease Control) and the rates of neonatology consultation and pregnancy option counseling. Results: In 138 periviable deliveries, 70.3% had a neonatology consultation, 92.0% were offered expectant management, 88.4% were offered neonatal full intervention, 41.3% were offered neonatal comfort care, and 44.9% were offered pregnancy termination. The rate at which neonatology consultations were completed and each pregnancy option was addressed did not differ by individual-level social vulnerability factors including race/ethnicity, government insurance, marital status, English proficiency, and parity, or by SVI. Conclusions: While these findings suggest that individual-level social vulnerability factors and SVI do not influence periviability counseling, we did identify gaps in comprehensive periviability counseling. Focus should be placed on increasing the rate of neonatology consultation and discussing the options of neonatal comfort care and pregnancy termination. Full article
(This article belongs to the Special Issue State of the Art: Updates in Preterm Labor and Preterm Birth)
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9 pages, 461 KiB  
Article
Effect of Social Vulnerability Index on Betamethasone Timing in Patients at Risk of Preterm Birth
by Lizelle Comfort, Gillian Piltch, David Krantz, Frank Jackson, Matthew J. Blitz and Burton Rochelson
J. Clin. Med. 2024, 13(24), 7798; https://doi.org/10.3390/jcm13247798 - 20 Dec 2024
Viewed by 567
Abstract
Background/Objectives: Several social vulnerability index (SVI) components have been associated with adverse obstetrical outcomes and provider bias. The objective of this study is to assess whether betamethasone administration timing among patients at risk for preterm birth differs by social vulnerability index. Methods: A [...] Read more.
Background/Objectives: Several social vulnerability index (SVI) components have been associated with adverse obstetrical outcomes and provider bias. The objective of this study is to assess whether betamethasone administration timing among patients at risk for preterm birth differs by social vulnerability index. Methods: A multicenter retrospective cohort study of pregnant people at a large academic healthcare system between January 2019 and January 2023. Patients with live singleton gestations at risk for preterm birth who received at least one dose of intramuscular betamethasone for fetal lung maturity from 22 to 34 weeks were included. Patients aged less than 18, who received late-preterm corticosteroids and/or had scheduled delivery at 34 weeks were excluded. We analyzed the association between patient SVI quartile and maternal demographic factors on betamethasone timing, with optimal timing defined as the receipt of two doses of betamethasone within 2 to 7 days of delivery. Results: 1686 patients met the inclusion criteria. Only 22.4% of patients had optimally timed betamethasone administration. Among those who did not receive optimal betamethasone timing, 360 patients delivered less than 48 h from the first dose and 948 delivered greater than 7 days from the first dose. Optimal betamethasone timing within 2 to 7 days of delivery was more common in patients with higher SVI values. Patients with lower social vulnerability were more likely to deliver greater than one week from betamethasone administration. Conclusions: Patients in higher SVI quartiles are more likely to have optimally timed betamethasone. This is likely attributed to overtreatment with betamethasone of less socially vulnerable populations. Full article
(This article belongs to the Special Issue State of the Art: Updates in Preterm Labor and Preterm Birth)
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