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Preterm Birth Rate Not Likely to Fall Anytime Soon.
VAIL, COLO. -- The glaring lack of success in preventing preterm birth over the past 20 years really should come as no surprise, Dr. Ronald S. Gibbs said at a conference on obstetrics and gynecology sponsored by the University of Colorado.
The basic underlying biology of preterm birth isn't yet understood. Until it is, it's not realistic to expect the preterm birth rate to fall, observed Dr. Gibbs, professor and chair of ob.gyn. at the University of Colorado Health Sciences Center, Denver.
For decades, the cornerstone of efforts to prevent preterm birth has been tocolytic therapy. This marginally effective therapy is a classic case of "too little, too late."
Proposed novel therapies have come along, often with great fanfare. Most have fallen by the wayside after failure in large trials.
It's possible that some of them truly are effective in preventing some cases of preterm birth, but their effects are diluted in clinical trials because preterm birth has multiple causes.
Still, there have been a few notable therapeutic successes.
These have mostly been in the area of adjunctive therapy aimed at preparing the preterm fetus for extrauterine life, not prevention of preterm birth.
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