Currently, treatment options for preventing preterm labor or birth are somewhat limited, in part because the cause of preterm labor or birth is often unknown. But there are a few options, described below.
Hormone treatment. The only preventive drug therapy is progesterone (pronounced proh-JES-tuh-rohn), a hormone produced by the body during pregnancy, which is given to women at risk of preterm birth, such as those with a prior preterm birth. The NICHD’s Maternal-Fetal Medicine Units Network found that progesterone given to women at risk of preterm birth due to a prior preterm birth reduces chances of a subsequent preterm birth by one-third. This preventive therapy is given beginning at 16 weeks of gestation and continues to 37 weeks of gestation.1,2 The treatment works among all ethnic groups and can improve outcomes for infants.
Cerclage. A surgical procedure called cervical cerclage (pronounced sair-KLAZH) is sometimes used to try to prevent early labor in women who have an incompetent (weak) cervix and have experienced early pregnancy loss accompanied by a painless opening (dilation) of the cervix (the bottom part of the uterus). In the cerclage procedure, a doctor stitches the cervix closed. The stitch is then removed closer to the woman's due date.
Bed rest. Contrary to expectations, confining the mother to bed rest does not help to prevent preterm birth. In fact, bed rest can make preterm birth even more likely among some women.3,4
Women should discuss all of their treatment options—including the risks and benefits—with their health care providers. If possible, these discussions should occur during regular prenatal care visits, before there is any urgency, to allow for a complete discussion of all the issues.
- Meis, P. J., Klebanoff, M., Thom, E., Dombrowski, M. P., Sibai, B., Moawad, A. H., et al. (2003). Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. New England Journal of Medicine, 348, 2379–2385. [top]
- American Congress of Obstetricians and Gynecologists, District II. (2009). Preventing preterm birth: The role of 17α hydroxyprogesterone caproate. Retrieved September 18, 2013, from https://www.acog.org/~/media/Announcements/20111013MakenaLtr.pdf (PDF – 1.84 MB) [top]
- Neergard, Lauran. (May 14, 2013). Bed Rest During Pregnancy May Worsen Risk For Premature Birth. Associated Press. Retrieved October 24, 2013, from http://www.huffingtonpost.com/2013/05/14/bed-rest-premature-birth_n_3272355.html [top]
- Grobman, W. A., Gilbert, S. A., Iams, J. D., Spong, C. Y., Saade, G., Mercer, B. M. (2013). Activity restriction among women with a short cervix. Obstetrics and Gynecology, 121(6), 1181–1186. [top]
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