Preterm (Premature) Labor and Birth: Resource Overview

When birth occurs between 20 and 37 weeks of pregnancy, it is called preterm, or premature, birth. Preterm labor begins with contractions of the uterus before 37 weeks of pregnancy that cause the cervix to thin out and open up. If preterm labor cannot be stopped, it leads to preterm birth.

Prematurity occurs in approximately 12% of all live births in the US, and preterm labor preceded approximately 50% of these preterm births. Preterm births account for approximately 70% of newborn deaths and 36% of infant deaths. Ob-gyns, physicians whose primary responsibility is women’s health, play a leading role in diagnosing and treating premature labor and birth.

Here are the key publications and resources for ob-gyns, other women’s health care providers, and patients from the American College of Obstetricians and Gynecologists (ACOG) and other sources.

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Resources for Ob-Gyns and Women’s Health Care Providers
Resources for Women and Patients
External Resources

Resources for Ob-Gyns and Women’s Health Care Providers

Committee Opinion: Antenatal Corticosteroid Therapy for Fetal Maturation

“Antenatal Corticosteroid Therapy for Fetal Maturation,” issued by ACOG in August 2017, provides evidence-based guidelines for the timing and frequency of corticosteroid administration under various clinical contexts before preterm birth.

Practice Bulletin: Prelabor Rupture of Membranes (members only)

“Prelabor Rupture of Membranes,” issued by ACOG in January 2018, provides evidence-based guidelines for the diagnosis, treatment, and management of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM). PROM is the rupture of membranes, or water breaking, before the onset of labor. When PROM occurs before 37 weeks of gestation it is referred to as PPROM.

Practice Bulletin: Management of Preterm Labor (members only)

“Management of Preterm Labor,” issued by ACOG in October 2016, provides clinical guidance for the management and intervention of premature labor. Use of corticosteroids, magnesium sulfate, tocolytic therapy, and antibiotics, as well as non-medical treatments such as bed rest, are covered.

Practice Bulletin: Cerclage for the Management of Cervical Insufficiency (members only)

“Cerclage for the Management of Cervical Insufficiency,” issued by ACOG in February 2014 (reaffirmed 2016), addresses the management of cervical insufficiency, or the inability of the cervix to retain a pregnancy in the second trimester. Screening methods, diagnosis, and treatment are covered, including cerclage, the use of stiches to hold the cervix closed.

Committee Opinion: Definition of Term Pregnancy

“Definition of Term Pregnancy,” issued by ACOG and the Society for Maternal-Fetal Medicine (SMFM) in November 2013 (reaffirmed 2015), provides new terminology to describe the time from 3 weeks before until 2 weeks after the estimated date of delivery: early term, full term, late term, and postterm. Neonatal outcomes vary widely within 37-42 weeks and new gestational age designations were developed to address those differences.

Committee Opinion: Magnesium Sulfate Use in Obstetrics

“Magnesium Sulfate Use in Obstetrics,” issued by ACOG and SMFM in January 2016, provides guidelines for the short-term use of magnesium sulfate for appropriate obstetric conditions. Uses include protecting the baby’s brain when a premature birth is anticipated and the short-term prolonging of pregnancy to allow for the administration of antenatal corticosteroids in certain women at risk of premature delivery.

Committee Opinion: Medically Indicated Late-Preterm and Early-Term Deliveries

“Medically Indicated Late-Preterm and Early-Term Deliveries,” issued by ACOG and SMFM in February 2019, addresses medically indicated induction or delivery  before 39 weeks of gestation to protect the health of the mother and baby, including the timing of delivery for specific medical indications. 

Committee Opinion: Nonmedically Indicated Early-Term Deliveries and Associated Neonatal Morbidities

"Nonmedically Indicated Early-Term Deliveries and Associated Neonatal Morbidities,” issued by ACOG and SMFM in February 2019, advises against deliveries before 39 weeks without a valid medical indication. It also provides guidelines on the role of amniocentesis to determine fetal pulmonary maturity.

Committee Opinion: Magnesium Sulfate Before Anticipated Preterm Birth for Neuroprotection

“Magnesium Sulfate Before Anticipated Preterm Birth for Neuroprotection,” issued by ACOG and SMFM in March 2010 (reaffirmed 2016), addresses the use of magnesium sulfate to protect the baby’s brain when a premature birth is anticipated. 

Practice Bulletin: Prediction and Prevention of Preterm Birth (members only)

“Prediction and Prevention of Preterm Birth,” issued by ACOG in October 2012 (reaffirmed 2012), reviews the evidence for various methods of screening and treating asymptomatic women at risk for premature birth. Treatment with progesterone and cerclage placement are reviewed, as well as cervical length screening.


Practice Bulletin: Multifetal Gestations: Twin, Triplet, and Higher-Order Multifetal Pregnancies

“Multifetal Gestations: Twin, Triplet, and Higher-Order Multifetal Pregnancies,” issued by ACOG in October 2016, reviews the complications associated with twin, triplet, and higher-order multifetal gestations and presents an evidence-based approach to management.

Resources for Women and Patients

Patient FAQ: Preterm Labor and Birth

“Preterm Labor and Birth,” issued by ACOG in January 2019, is designed to answer patients’ questions about premature labor and premature birth. The document covers the signs of premature labor, methods of diagnosis, and available treatment options.

Patient FAQ: Extremely Preterm Birth

“Extremely Preterm Birth,” issued by ACOG in June 2016, provides information for patients on extremely preterm birth, defined as babies born before 28 completed weeks of pregnancy. It discusses the possible complications of extremely preterm birth and the treatment and management options available.

Patient FAQ:  Multiple Pregnancy

“Multiple Pregnancy,” issued by ACOG in July 2015, explains the causes and symptoms of multiple pregnancy and answers questions about how multiple pregnancy may affect a patient’s risk of preeclampsia, gestational diabetes, and fetal growth. 

External Resources

March of Dimes

March of Dimes raises awareness for and supports research to find the cause of prematurity, helping mothers to have full-term pregnancies and healthy babies. the organization also offers information and comfort to families of premature babies. 

Society for Maternal Fetal Medicine

The Society for Maternal Fetal Medicine is dedicated to improving maternal and child outcomes and raising the standards of prevention, diagnosis, and treatment of maternal and fetal disease through support for the clinical practice of maternal-fetal medicine research, education/training, advocacy, and health policy leadership.


The American College of Obstetricians and Gynecologists (ACOG), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality women’s health care, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care.


American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998