Our new podcast episode features Dr Roberto Romero and Prof. Fabricio Da Silva Costa.
Professor Fabricio Da Silva Costa, Consultant at the Maternal Fetal Medicine Unit, Gold Coast University Hospital and Professor of Obstetrics and Gynaecology at Griffith University, interviews Dr Roberto Romero. Dr Roberto is a leading specialist in preterm birth and Chief of the Pregnancy/Perinatology Research Branch (PRB) and Head of the Program for Perinatal Research and Obstetrics in the Division of Intramural Research of NICHD.
Dr Romero highlights preterm birth as a critical issue impacting millions worldwide. Preterm birth is defined as any birth occurring between viability (around 20 weeks) and 37 weeks of gestation. Late preterm births (35-37 weeks) account for approximately 70% of all preterm cases. Reasons for preterm birth include spontaneous labor or medically indicated early delivery due to maternal or fetal health concerns.
Preterm birth is the leading cause of mortality in children under five and varies significantly across regions. The highest rates are in Asia and Africa, while Europe—especially Scandinavian countries—has the lowest rates. The United States also has a high rate of preterm births, influenced by socioeconomic disparities among different population groups. In low-income settings, lack of essential newborn care for babies born at or below 32 weeks often leads to high mortality rates. These babies, if they survive, face a lifetime of health challenges, emphasising the socio-economic burden of preterm birth.
Clinicians sometimes face challenging decisions regarding early delivery. While spontaneous preterm birth remains difficult to prevent entirely, advances in screening and prediction offer improvements.
Dr Roberto emphasises the importance of individualised risk assessment and intervention. Measuring cervical length between 18 and 23 weeks is a simple but effective method for predicting preterm risk. If a short cervix is identified, administering vaginal progesterone has shown to be an effective intervention. Evidence has shown that universally implementing such screening strategy is more effective than any other intervention, highlighting that progress is possible through practical, evidence-based approaches.
Overall, Dr Roberto and Prof. Costa truly highlight preterm birth as a complex complication that poses a risk to the baby and the mother. Whilst the baby faces the risk of mortality and long-term health issues associated with prematurity, the mother who experiences preterm birth, has increased risks to their health as well.
The key to reducing preterm birth rates lies in early prediction and intervention, as well as ensuring these methods are accessible in clinical practice worldwide.
Further information on this important topic can also be found in the Advanced Training Curriculum course on Preterm birth and cervical assessment as well as the VISUOG article on the cervix in the second trimester.
You can also access the ISUOG Practice Guidelines on the role of ultrasound in the prediction of spontaneous preterm birth here.
Listen to the full episode on our ISUOG Podcast here: