Preterm birth accounts for 50–70% of all neonatal mortality and morbidity. Despite advances in obstetric care the incidence of preterm birth in developed countries remains at approximately 10% of all births. The consequences of preterm birth often continue beyond the neonatal period and can lead to significant direct and indirect costs that have to be borne by society and the parents. Tocolysis provides a useful short-term delay in preterm birth, which in turn allows in utero transfer and corticosteroid administration to be performed. The impact of these interventions on neonatal mortality and morbidity is dependent upon many factors including the gestational age at the time of treatment.
The First International Preterm Labour Congress focused on the strategies used to prevent the morbidity and mortality associated with prematurity. The Congress was held in Montreux, Switzerland, in June 2002, and was attended by over 400 expert neonatologists and obstetricians from all over the world. An interesting and diverse range of subjects relating to preterm labour and preterm birth were presented and debated over three days. Each of the six sessions dealt with a specific topic: importance of preterm birth, aetiology of preterm labour, prediction and prevention of preterm labour, management of preterm labour, tocolytic therapy and clinical experience and, finally, future directions and goals in the management of preterm labour.
This meeting represented only the second occasion in 25 years, since the 6th Study Group of the RCOG on Preterm Labour in 1977 and the 13th Study Group on preterm birth in 1985, that a large body of opinion leaders in the field of spontaneous preterm labour and preterm birth have met to discuss the problem. Major advances have been achieved since that time in our appreciation of the beneficial roles of antepartum glucocorticoids, and in the development of new tocolytic agents, which are uterospecific and developed solely for the treatment of spontaneous preterm labour. Our understanding of the biochemical, physiological, endocrinological, paracrinological and molecular biology of labour has greatly improved as has our understanding of the role of abnormal flora leading to infection and inflammation in the mechanism of spontaneous preterm labour and preterm birth.
The Preterm Labour Congress provided an ideal opportunity to share current opinions regarding preterm labour and preterm birth and also to discuss ways forward to resolve this continuing problem.
We would like to thank the authors, sponsors and British Journal of Obstetrics and Gynaecology editorial team for their contribution towards this supplement. Hopefully, in the future we will collaborate again for the second Preterm Labour Congress which is due to be held in 2004.