This EAPM Good Practice Recommendation reviews the epidemiology, aetiology, risk factors, microbiome role, and evidence-based prevention and management strategies for spontaneous preterm birth (sPTB) across European settings.
Preterm birth affects 5–12% of live births in Europe, remains a leading cause of neonatal mortality and morbidity, and rates are rising in several European countries despite decades of research; the paper advocates a multicomponent primary, secondary, and tertiary prevention approach.
As a good practice recommendation rather than a systematic review or RCT, the document synthesises existing evidence without original data or formal meta-analysis, limiting the strength of individual recommendations.
Clinicians should adopt a structured, multicomponent approach to sPTB—combining risk stratification, microbiome-informed care, and evidence-based preventive interventions across all three levels of prevention. Relying on single-strategy approaches has not reduced the overall burden and should be reconsidered.
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