Evolving strategies target infection-induced preterm labor. (Could Cut Preterm Birth Rate By 30%).

NEW ORLEANS -- The prevention of infection-induced preterm birth could reduce the overall rate of preterm birth by as much as 30%, Dr. Ronald Gibbs said at the annual meeting of the American College of Obstetricians and Gynecologists.

But this rapidly evolving field, rife with conflicting studies, is an ongoing challenge for practicing clinicians to keep up with, said Dr. Gibbs, who is professor and chair of obstetrics and gynecology at the University of Colorado, Denver.

Subclinical infection, the dangers of treating certain infections, and the persistence of infection despite treatment are some of the dilemmas faced by practitioners.

The key to preventing infection-induced preterm birth is the recognition of several points of intervention because several factors may contribute to this type of preterm birth, he said.

Many experts hypothesize that it is a combination of infection and genetic susceptibility in the mother that starts the preterm labor cascade.

The presence of abnormal microbes--whether from bacterial vaginosis (BV), other vaginal infections, pyelonephritis, or periodontitis--upregulates a cytokine and prostaglandin cascade in genetically predisposed women, which may ...