The risk of preterm birth can be reduced in several ways: through primary prevention, secondary prevention, or tertiary prevention.
Prevention
Primary prevention
Primary prevention focuses on general health and a healthy lifestyle before and during pregnancy to help reduce the risk of complications such as preterm birth. A healthy lifestyle includes:
- Eating a balanced diet with plenty of well‑washed fruits and vegetables, whole‑grain products such as brown rice and whole‑grain bread, and protein sources such as fish, dairy, or meat
- Drinking enough water (about 1.5 liters per day)
- Avoiding sugary drinks, high‑sugar or high‑fat snacks, and raw animal products
- Engaging in regular physical activity: choosing activities that feel comfortable and safe, avoiding contact sports or activities with a high risk of falling or sudden movements; as pregnancy progresses, gentle exercises such as swimming and yoga are ideal
- Not smoking (including avoiding exposure to secondhand smoke from partners or others)
- Avoiding the use of alcohol or drugs
- Taking good care of mental and emotional well‑being by incorporating moments of relaxation: techniques such as breathing exercises, taking a warm bath or shower, or walking calmly in nature can help promote a sense of calm
Although lifestyle changes play an important role in supporting a healthy pregnancy, they cannot always prevent a baby from being born too early.
Secondary prevention
Secondary prevention of preterm birth focuses on women who already have an increased risk based on their medical history. The emphasis lies on early identification and treatment of risk factors during the current pregnancy.
Progesterone may be prescribed in cases of a previous preterm birth or when the cervical length is shortened (measured by transvaginal ultrasound). In certain situations, a cerclage may be considered: a stitch placed around the cervix to help delay preterm birth. This procedure is not always feasible, and the decision is made by the medical team.
It is also important to screen early in pregnancy for a possible urinary tract infection, even in the absence of symptoms. If bacteria are detected in the urine, timely initiation of antibiotics can prevent complications for the mother and the baby.
For women at increased risk of preterm birth, the use of aspirin can reduce the likelihood of pregnancy complications such as preeclampsia.
Tertiary prevention
When preterm contractions or premature rupture of membranes occur, the focus shifts to optimizing care for the baby. The primary purpose of administering tocolytics (medications that suppress contractions) is to allow enough time for corticosteroids to be given and to take effect, promoting fetal lung maturation. Tocolysis also makes it possible to transfer the mother to a specialized center (intra‑uterine transport). If the membranes have ruptured (PPROM), antibiotics may be required to prevent infection. When birth before 32 weeks is anticipated, magnesium sulfate (MgSO₄) is recommended for neuroprotection of the baby.
In cases of preeclampsia, symptomatic treatment is initiated, focusing on lowering blood pressure, preventing eclampsia (with magnesium sulfate), and closely monitoring both mother and baby.
For other complications, such as placenta previa, placental abruption, intrahepatic cholestasis of pregnancy, or other maternal problems, the underlying cause is addressed specifically, with the goal of reducing risks for both mother and baby and determining the safest possible timing of delivery.