Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry Number 015/025, September 2022) – Part 1 with Recommendations on the Epidemiology, Etiology, Prediction, Primary and Secondary Prevention of Preterm Birth

Abstract

Aim This revised guideline was coordinated by the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (OEGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). It aims to improve the prediction, prevention, and management of preterm birth, based on evidence from the current literature, the experience of members of the guidelines commission, and the viewpoint of self-help organizations. Methods The members of the contributing professional societies and organizations developed recommendations and statements based on international literature. The recommendations and statements were presented and adopted using a formal process (structured consensus conferences with neutral moderation, written Delphi vote). Recommendations Part 1 of this short version of the guideline presents statements and recommendations on the epidemiology, etiology, prediction, and primary and secondary prevention of preterm birth.

Reducing the Rate of Premature Births through Early Diagnosis and Pregnancy-Adapted Treatment of Hypothyroidism

“…Es entwickelt sich eine physiologische euthyreote maternale Hyperthyroxinämie, die erst 14 Tage nach der Entbindung abklingt [25,26]. Frauen leiden im Vergleich zu Männern 5-mal häufiger an latenten und manifesten Hypothyreosen, dennoch wird die mütterliche Schilddrüsenfunktion zur Prävention der Frühgeburt bisher wenig beachtet [5,7,8].…”

“…Sie ist innerhalb der Europäischen Union eine der höchsten [6]. 70% werden ätiologisch dem Formenkreis der spontanen Frühgeburten zugeordnet [5,7,8,9], während 30% medizinische Ursachen haben und iatrogen induziert sind. Über die letzten Jahrzehnte zeigt die Frühgeburtenrate in Deutschland insgesamt eine stabile Prävalenz, wobei die Zahl der frühen Frühgeburten unter der 28.…”

“…In den Leitlinien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. vom Oktober 2022 zur Prävention und Therapie der Frühgeburt wird die Schilddrüsenunterfunktion als behandlungsbedürftiger Risikofaktor nicht erwähnt [5,7,8].…”

Possible Rates of Detection of Neonatal Sepsis Pathogens in the Context of Microbiological Diagnostics in Mothers – Real World Data

“…Some authors recommend general microbiological diagnostics in risk situations, such as premature rupture of membranes and in the case of premature contractions [14]. In the German guidelines "Full-Term Vaginal Birth -S3 guideline" and "Prevention and Therapy of Preterm Birth -S2k guideline", this diagnostic procedure is not generally recommended [21,22,23,24,25]; nevertheless, it is largely implemented in clinical practice in Germany. In other guidelines, maternal microbiological diagnostics are not mentioned or do not play a role at all, and only preventive maternal antibiotic administration is recommended [23,26].…”

“…In the German guidelines "Full-Term Vaginal Birth -S3 guideline" and "Prevention and Therapy of Preterm Birth -S2k guideline", this diagnostic procedure is not generally recommended [21,22,23,24,25]; nevertheless, it is largely implemented in clinical practice in Germany. In other guidelines, maternal microbiological diagnostics are not mentioned or do not play a role at all, and only preventive maternal antibiotic administration is recommended [23,26]. Studies with data on concordance of smear results between mothers and their children in the case of sepsis are rare.…”