Medical progress - Prevention of premature birth

The available data on the effectiveness of various interventions aimed at reducing premature births provide an explanation for the epidemiologic observation that the rate of preterm birth is not declining. Most interventions designed to prevent preterm birth do not work, and the few that do, including treatment of urinary tract infection, cerclage, and treatment of bacterial vaginosis in high-risk women, are not universally effective and are applicable to only a small percentage of women at risk for preterm birth. A more rational approach to intervention will require a better understanding of the mechanisms leading to preterm birth. In the meantime, substantial reductions in preterm delivery are unlikely to be achieved.