Abstract：
Preterm birth (PTB), remains a major cause of significant morbidity and mortality world-wide with about 12-15million preterm births occurring every year. Although the overall trend is decreasing, this is mainly in high-income countries (HIC). The rate remains high in low-and middle-income countries (LMIC) varying on average between 10 and 12% compared to 9% in HIC. The pathogenesis of PTB is complex and multifactorial. Attempts to reduce rates that have focused on PTB as a single condition have in general been unsuccessful. However, more recent attempts to phenotype PTB have resulted in targeted preventative approaches which are yielding better results. Prevention (primary or secondary) is the only approach that has been shown to make a difference to rates of PTB. These include identifying risk factors pre-pregnancy and during pregnancy and instituting appropriate measures to address these. In LMIC, although some approaches that have been shown to be effective in some HIC are adaptable, there is a need to involve stakeholders at all levels in utilizing evidence preferrably generated in LMIC to implement strategies that are likely to reduce the rate of PTB. In this review, we focus on prevention and how to involve policy makers in the process of applying evidence into policy that would reduce PTB in LMIC.
摘要：
早产（PTB），仍然是世界范围内发病率和死亡率高的主要原因，每年约有12-1500万早产。虽然总体趋势在下降,这主要是在高收入国家（HIC）。低收入和中等收入国家（LMIC）的比率仍然很高，平均在10％至12％之间，而HIC为9％。PTB的发病机制复杂且多因素。试图降低以PTB为单一状况的比率通常是不成功的。然而,最近对PTB表型的尝试已经产生了靶向预防方法,这些方法产生了更好的结果.预防（主要或次要）是唯一已被证明对PTB发生率有影响的方法。这些措施包括确定怀孕前和怀孕期间的风险因素，并采取适当的措施来解决这些问题。在LMIC中,尽管一些在某些HIC中被证明有效的方法是可适应的，有必要让各级利益相关者参与利用LMIC中优选产生的证据来实施可能降低PTB发生率的策略.在这次审查中,我们的重点是预防，以及如何让决策者参与将证据应用于减少LMIC中PTB的政策的过程。
