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    Rising preterm birth rates: Time to double down on our efforts


    Given these studies I would contend that progesterone therapy is best started early and, ideally prophylactically. Thus, I would recommend 17-OHP starting at 16 weeks in women with prior PTBs and high-dose vaginal progesterone for asymptomatic women with shortened cervix ≤20 mm, ideally started at 10 to 22 weeks, but certainly no later than 24 weeks and only if there is no evidence of infection or active abruption.


    Take-home message

    The recent national uptick in PTB rates may reflect the aging of our maternity population with its attendant accumulation of comorbidities triggering indicated PTBs. However, this increase should be a reminder that we must all do our best to optimize our patients’ lifestyle choices, BMI, fitness levels, and medical regimens prior to conception to reduce indicated PTBs. We should also fully employ the 7 practices described above that are known to reduce PTB rates. Our struggle against PTB is far from over and now is the time to redouble our efforts.



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    Charles J. Lockwood, MD, MHCM
    Dr. Lockwood, Editor-in-Chief, is Dean of the Morsani College of Medicine and Senior Vice President of USF Health, University of South ...


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