Worldwide, 15 million children are born prematurely each year, that is, after less than 37 weeks of pregnancy. In the Netherlands this is more than 11,000 children per year. Annually 661 children die around birth. If you count from 24 weeks of pregnancy, 420 of these die due to premature birth. Counting from 16 weeks of pregnancy, that number is much higher. Clear data that calls for a targeted approach. However, many factors play a role in preterm birth.

Focus on prevention
Martijn Oudijk Oudijk pronounced his inauguration as Professor of Prevention and Treatment of Preterm Birth on Thursday, May 12. In his inaugural lecture he focused on issues that can influence preterm birth. Various studies have shown that healthy eating and sufficient exercise have a positive effect on the outcome of pregnancy. However, most women do not know that they themselves can make an important contribution to a successful pregnancy. Oudijk: "With a public campaign about the effects of a healthy lifestyle on pregnancy, we can reduce the number of pregnancy complications, including preterm birth."

In addition to a healthy lifestyle, much can be gained from some simple interventions, Oudijk explains. For example, recent research shows that the use of omega-3 fish oil leads to a reduction in the number of preterm births under 37 weeks by more than 10 percent. The number of premature births under 34 weeks even drops by 40 percent. Oudijk: "The Health Council advises pregnant women to eat fish twice a week. If they don't achieve that, they can also take omega-3 fish oil capsules. A simple and safe way to prevent premature births." Studies also show that taking aspirin reduces pre-eclampsia and preterm birth by 10 percent. Oudijk: "I think in the short term we should advise all pregnant women to start taking aspirin."

Measuring the cervix
A short cervix is also thought to play a role in preterm birth. Therefore, a 20-week ultrasound is not complete without a measurement of the cervix. Oudijk: "I do not think that introducing this measurement as standard medicalizes the pregnancy. On the contrary, you take women seriously." A proven effective therapy to reduce the risk of preterm birth due to a too short cervix is progesterone. This hormone reduces the risk of preterm birth by 35 percent.

Harmful interventions
But gynecologists themselves must also be critical of their actions. Certain interventions, such as curettage in the case of an abortion or a pregnancy that has already gone wrong at an early stage, are known to have an influence on preterm birth. Oudijk: "You have to inform women about the consequences of such an intervention for a future pregnancy. A gynecologist may be better advised to wait if a pregnancy goes wrong before 10 weeks. After all, the chances of a spontaneous miscarriage are high and there are also options with medication." Abortion care in the Netherlands should also be organized differently, Oudijk argues. "Women in the Netherlands fortunately have access to safe abortion care. But there should be attention to the long-term effects. Medicated termination is certainly safe and less risky if women want to get pregnant again later."