Stratification of preterm birth risk: peculiarities

According to the official statistics, in Perm region a number of preterm births (PB) has declined by 1.5% over the last 10 years; however, PB is still a leading cause for neonatal mortality. Despite a lot of already performed research and studies that are being performed at the moment, there is still no clear understanding what etiological factors cause PB. The paper contains a literature review of research that focused on PB risk factors. Certain factors are generally recognized and included into «Preterm birth» clinical report (2013), but literature data analysis allowed revealing additional PB risk factors. Cervical incompetence (CI) is a generally recognized PB risk factor. In 2018 clinical recommendations were published; they contained a list of CI risk factors and some of them coincided with PB risk factors (bad habits, extreme anthropometric parameters, peculiarities in obstetric and gynecologic case history, certain extra-genital diseases, multiple pregnancy, application of assisted reproductive technologies, complicated pregnancy); some others are considered to cause only CI (application of anti-tumor hormonal preparations, CI in family case history, abnormal development and disorders in the structure of female genital organs, surgeries on ovaries in case history). We performed comparative analysis of PB and CI risk factors and it helped us substantiate a necessity to create a unified list of PB risk factors as it would allow optimizing not only procedures applied to rank female patients but also accomplishing relevant PB prevention.