Preterm Birth Is a Syndrome, Not a Disease

During the past several decades we have made relatively few strides in preventing preterm birth — an entity responsible for a great proportion of neonatal morbidity and mortality. This may be partly due to our approach to prematurity with sometimes-unproven therapies (e.g., tocolytics, antibiotics, activity restriction) and a failure to recognize distinct precursors and phenotypes that might lend themselves to more-targeted strategies. A multinational team of investigators explored outcomes in a cross-sectional study of nearly 60,000 newborns to identify distinct subtypes of preterm births based on an a priori conceptual framework.

Preterm births (<37 weeks' gestation) occurred in 11% of the cohort and were categorized into 1 of 12 clusters …