FIGO good practice recommendations on modifiable causes of iatrogenic preterm birth

Abstract

Iatrogenic preterm birth is a planned delivery that occurs before 37 weeks of gestation due to maternal and/or fetal causes. However, in some cases, such deliveries also occur with no apparent medical indication. The increasing numbers of iatrogenic preterm deliveries worldwide have led researchers to identify modifiable causes that allow the formulation of preventive strategies that could impact the overall preterm birth rate. The present document contains the FIGO (International Federation of Gynecology and Obstetrics) Working Group for Preterm Birth recommendations, aiming to reduce the rates of iatrogenic preterm birth based on four of the most common clinical scenarios and issues related to iatrogenic preterm delivery. The working group supports efforts to identify the contribution of iatrogenic preterm delivery to the overall preterm birth rate and encourages health authorities to establish preventive measures accordingly. We encourage care providers to maintain single embryo transfer policies to prevent multiple pregnancies as a substantial contributor of iatrogenic preterm birth. The working group also recommends that efforts to reduce unnecessary cesarean sections must be warranted, and mechanisms to ensure the appropriate time of delivery and strengthening of education and communication processes must be pursued.

FIGO good practice recommendations for reducing preterm birth and improving child outcomes

“…When consensus was reached, Working Group recommendations were in alignment with FIGO policy. Documents were stratified into three categories with recommendations provided: population-based registries [1][2][3] ; prevention by maternal treatment [4][5][6] ; and fetal treatment imminent to delivery. [7][8][9]…”

Evaluation of the effects of COVID‐19 disease and the trimester in which the disease is diagnosed on obstetric and neonatal outcomes: A retrospective cohort study

“…Premature birth rates determined according to 34 and 37 weeks of gestation were additionally compared between groups determined according to the trimester in which COVID‐19 passed. Iatrogenic preterm birth is defined as labor induction or cesarean delivery before 37 weeks without spontaneous labor or rupture of membranes 9 . In this study, the causes of preterm birth in pregnant women who had and did not have COVID‐19 were grouped as iatrogenic and spontaneous and compared.…”

“…Iatrogenic preterm birth is defined as labor induction or cesarean delivery before 37 weeks without spontaneous labor or rupture of membranes. 9 In this study, the causes of preterm birth in pregnant women who had and did not have COVID-19 were grouped as iatrogenic and spontaneous and compared. In addition to all these, the indications for cesarean section in patients who have had a cesarean section after having had COVID-19 and the causes of preterm delivery in patients who have had a preterm delivery after having had COVID-19 were examined.…”

Letter to the editor: FIGO good practice recommendations on modifiable causes of iatrogenic preterm birth

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We read with great interest the FIGO good practice recommendations on modifiable causes of iatrogenic preterm birth. 1 Avoiding iatrogenic prematurity should be one of the main goals of all obstetricians. The balance between maternal and fetal morbidity/mortality is sometimes difficult to establish; especially with regard to pregnancy-induced hypertension, a condition that carries a considerable risk for the mother.

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“…We read with great interest the FIGO good practice recommendations on modifiable causes of iatrogenic preterm birth 1 . Avoiding iatrogenic prematurity should be one of the main goals of all obstetricians.…”