Interventions for the prevention of spontaneous preterm birth: a scoping review of systematic reviews
BMJ Open 2022;12:e052576. doi:10.1136/bmjopen-2021-052576
Fiona Campbell1, Shumona Salam2, Anthea Sutton1, Shamanthi Maya Jayasooriya3, Caroline Mitchell3, Emmanuel Amabebe2, Julie Balen1, Bronwen M Gillespie2, Kerry Parris2, Priya Soma-Pillay4, Lawrence Chauke5, Brenda Narice2, Dilichukwu O Anumba2
Correspondence to Dr Fiona Campbell; f.campbell at sheffield.ac.uk
Background Globally, 11% of babies are born preterm each year. Preterm birth (PTB) is a leading cause of neonatal death and under-five mortality and morbidity, with lifelong sequelae in those who survive. PTB disproportionately impacts low/middle-income countries (LMICs) where the burden is highest.
Objectives This scoping review sought to the evidence for interventions that reduce the risk of PTB, focusing on the evidence from LMICs and describing how context is considered in evidence synthesis.
Design We conducted a scoping review, to describe this wide topic area. We searched five electronic databases (2009–2020) and contacted experts to identify relevant systematic reviews of interventions to reduce the risk of PTB. We included published systematic reviews that examined the effectiveness of interventions and their effect on reducing the risk of PTB. Data were extracted and is described narratively.
Results 139 published systematic reviews were included in the review. Interventions were categorised as primary or secondary. The interventions where the results showed a greater effect size and consistency across review findings included treatment of syphilis and vaginal candidiasis, vitamin D supplementation and cervical cerclage. Included in the 139 reviews were 1372 unique primary source studies. 28% primary studies were undertaken in LMIC contexts and only 4.5% undertaken in a low-income country (LIC) Only 10.8% of the reviews sought to explore the impact of context on findings, and 19.4% reviews did not report the settings or the primary studies.
Conclusion This scoping review highlights the lack of research evidence derived from contexts where the burden of PTB globally is greatest. The lack of rigour in addressing contextual applicability within systematic review methods is also highlighted. This presents a risk of inappropriate and unsafe recommendations for practice within these contexts. It also highlights a need for primary research, developing and testing interventions in LIC settings.
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VitaminDWiki Pregnancy pages with PRETERM of PRE-TERM in title (61 as of May 2022)
This list is automatically updated
Items found: 65
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Preterm Birth 2.7X more likely if low vitamin D (dark skin in this case) - Nov 2023 |
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01 Nov, 2023 |
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4.4 X more likely to have a preterm birth if low vitamin D while pregnant (India) - May 2022 |
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01 Nov, 2023 |
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Preterm birth 7 X more likely if both low vitamin D and high PTH 1 month before birth – May 2023 |
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23 May, 2023 |
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Omega-3 supplementation reduced preterm birth rate by 4X – RCT July 2020 |
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21 Oct, 2022 |
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Preterm birth decreased by Omege-3, etc. - many studies |
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21 Oct, 2022 |
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Arab preterm infants often have less than 10 ng of vitamin D - 2010 |
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15 May, 2022 |
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Preterm birth interventions – 4 studies found possible vitamin D benefit – Cochrane – Nov 2018 |
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15 May, 2022 |
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Preterm birth might be prevented by Vitamin D, Omega-3, etc. (International survey) – Jan 2019 |
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15 May, 2022 |
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Preterm Births - promising preventions – anti-oxidants, Vitamin D, Omega-3, Zinc, etc. – Jan 2019 |
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15 May, 2022 |
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Preterm birth chance reduced – with 17P or Vitamin D – June 2015 |
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15 May, 2022 |
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Preterm birth reduction by nutrients - Vitamin D is the best, Omega-3 is next best – May 2022 |
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15 May, 2022 |
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Preterm birth rate of pregnant smokers cut in half if take Omega-3 – RCT May 2017 |
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20 Feb, 2022 |
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Preterm birth varies with season: 25 percent more likely if conception in autumn – Feb 2022 |
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04 Feb, 2022 |
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Pre-term birth rate cut in half with 1000 milligrams of Omega-3 (if initially low) – RCT May 2021 |
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04 Jun, 2021 |
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Preterm birth risk increased 16 pcnt if heat wave (perhaps outside less) - Nov 2020 |
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16 Nov, 2020 |
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Preterm birth associated with many genes, including the Vitamin D Receptor again – Jan 2020 |
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30 Jan, 2020 |
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Preterm birth 8X more likely if poor Vitamin D Receptor – Dec 2019 |
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31 Dec, 2019 |
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8 percent fewer preterm births if adequate Selenium from food – Aug 2019 |
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24 Dec, 2019 |
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Pregnant women in Australia to take Omega-3 when told of reduction in preterm births – Dec 2019 |
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19 Nov, 2019 |
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Preterm birth 9 X more likely if fetus had a poor Vitamin D Receptor and previous miscarriage – Aug 2017 |
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12 Nov, 2019 |
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Preterm birth rate not vary with vitamin D level (when all are less than 30 ng) – Oct 2019 |
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17 Oct, 2019 |
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Extreme preterm infants helped somewhat by 800 IU of vitamin D – RCT Jan 2018 |
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01 Oct, 2019 |
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Preterm Births reduced by Omega-3, Zinc, and Vitamin D – Aug 2019 |
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09 Aug, 2019 |
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Preterm birth increases risk of heart disease by 1.5 X by age 40 – June 2019 |
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06 Aug, 2019 |
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Preterm Births decreased by Omega-3 (analysis of 184 countries) – April 2019 |
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27 Apr, 2019 |
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Preterm birth 3X more likely if low vitamin D – Oct 2018 |
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07 Feb, 2019 |
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Omega-3 index of 5 greatly decreases the risk of an early preterm birth – Dec 2018 |
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04 Jan, 2019 |
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Preterm birth cost for employers approximately 50,000 dollars – Oct 2017 |
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28 Sep, 2018 |
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Preterm births 12 X more likely if poor Vitamin D Receptor (white infants in Italy) – meta-analysis Aug 2018 |
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27 Aug, 2018 |
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Third trimester Vitamin D levels were lower if pre-term labor was expected – March 2018 |
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24 Mar, 2018 |
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Preterm birth 4X more likely if very low Vitamin D (Chinese) - Feb 2018 |
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28 Feb, 2018 |
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Preterm birth rates increased in 15 European countries – Oct 2013 |
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23 Dec, 2017 |
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Vitamin D intervention reduces preterm births and low birth weight by 60 percent – Cochrane Reviews – Nov 2017 |
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07 Dec, 2017 |
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Preterm birth rate increased 60 percent in 50 years (US) |
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26 Nov, 2017 |
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Preterm births are VERY costly – Feb 2017 |
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26 Nov, 2017 |
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Preterm births strongly related to Vitamin D, Vitamin D Receptor, Iodine, Omega-3, etc |
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13 Nov, 2017 |
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Vitamin D Receptor is associated with preeclampsia, gestational diabetes and preterm birth – Nov 2017 |
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10 Nov, 2017 |
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Preterm birth trend toward 2.5 X more likely if less than 10 ng of Vitamin D – Aug 2017 |
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26 Aug, 2017 |
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Preterm birth rate reduced by vitamin D – 78 percent if non-white, 39 percent if white – July 2017 |
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27 Jul, 2017 |
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Preterm birth more likely if dark skinned and low vitamin D (not white-skinned) – April 2017 |
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06 Jul, 2017 |
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Risk of preterm birth twice as likely when less than 10 ng of vitamin D – Nov 2016 |
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13 Apr, 2017 |
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Preterm labor 20 times more likely if low vitamin D, etc. (India) – Feb 2017 |
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08 Mar, 2017 |
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Preterm birth rate reduced by 43 percent with adequate Vitamin D supplementation – meta-analysis Feb 2017 |
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02 Mar, 2017 |
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Pre-term birth - many of risk factors are associated with low vitamin D |
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27 Feb, 2017 |
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Preterm birth rate reduced 57 percent by Vitamin D – Nov 2015 |
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23 Jan, 2017 |
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Vitamin D Webinar - cost of pre-term birth etc- Baggerly Nov 2013 |
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11 Dec, 2016 |
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Preterm birth extended by 2 weeks with Omega-3 – Meta-analysis Nov 2015 |
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10 Dec, 2016 |
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Omega-3 supplementation during pregnancy reduce early preterm births (save 1500 USD per child) – Aug 2016 |
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12 Oct, 2016 |
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Zinc helps pregnancies – 14 percent fewer preterm births, etc. – Cochrane RCT Feb 2015 |
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14 Jun, 2016 |
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Preterm birth has become the leading cause of infant mortality (vitamin D not mentioned) – JAMA June 2016 |
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07 Jun, 2016 |
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Preterm birth 30 percent more likely if low vitamin D – meta-analysis May 2016 |
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20 May, 2016 |
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Asthmatic pregnant women had 30 percent more preterm births if air pollution (vitamin D not mentioned) – March 2016 |
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09 Mar, 2016 |
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Omega-3 helps pregnancy in many ways: preterm 26 percent less likely etc – review July 2012 |
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08 Sep, 2015 |
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Extreme preterm survival 30 percent less likely if little sunshine 23-28 weeks – June 2015 |
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05 Sep, 2015 |
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Magnesium (Sulfate) reduces risk of cerebral palsy for those at risk of pre-term births – Dec 2013 |
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18 Aug, 2015 |
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Respiratory distress after preterm birth is more likely if low vitamin D – review April 2015 |
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05 Aug, 2015 |
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Pre-term births reduced in half if 40 ng of vitamin D in 3rd trimester – Nov 2014 |
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15 Mar, 2015 |
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Chance of preterm birth is strongly associated with low vitamin D – Feb 2015 |
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05 Feb, 2015 |
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The more preterm the birth, the lower the vitamin D level (both mothers and infants) – Feb 2014 |
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05 Feb, 2015 |
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Preterm infants more likely to have vitamin D levels below 20 ng – Feb 2014 |
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05 Feb, 2015 |
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Decreased risk of preterm birth if have more than 36 ng of vitamin D – Jan 2015 |
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09 Jan, 2015 |
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Pre-term birth 3X more likely and C-section 4X if less than 20 ng of vitamin D – May 2012 |
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13 Feb, 2014 |
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Recurrent pre term birth and low vitamin D – Dec 2012 |
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23 Jan, 2013 |
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Blacks have more pre-term births due to low nutrients such as vitamin D – Sept 2011 |
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14 Sep, 2011 |
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Pre-term birth not associated with first tri-mester vitamin D – April 2011 |
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21 Apr, 2011 |
VitaminDWiki Omega-3 pages with PRETERM of PRE-TERM in title (13 as of May 2022)
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Items found: 16
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Omega-3 supplementation reduced preterm birth rate by 4X – RCT July 2020 |
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21 Oct, 2022 |
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Preterm birth decreased by Omege-3, etc. - many studies |
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21 Oct, 2022 |
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Preterm birth might be prevented by Vitamin D, Omega-3, etc. (International survey) – Jan 2019 |
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15 May, 2022 |
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Preterm Births - promising preventions – anti-oxidants, Vitamin D, Omega-3, Zinc, etc. – Jan 2019 |
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15 May, 2022 |
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Preterm birth reduction by nutrients - Vitamin D is the best, Omega-3 is next best – May 2022 |
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15 May, 2022 |
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Preterm birth rate of pregnant smokers cut in half if take Omega-3 – RCT May 2017 |
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20 Feb, 2022 |
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Pre-term birth rate cut in half with 1000 milligrams of Omega-3 (if initially low) – RCT May 2021 |
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04 Jun, 2021 |
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Pregnant women in Australia to take Omega-3 when told of reduction in preterm births – Dec 2019 |
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19 Nov, 2019 |
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Preterm Births reduced by Omega-3, Zinc, and Vitamin D – Aug 2019 |
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09 Aug, 2019 |
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Preterm Births decreased by Omega-3 (analysis of 184 countries) – April 2019 |
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27 Apr, 2019 |
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Omega-3 index of 5 greatly decreases the risk of an early preterm birth – Dec 2018 |
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04 Jan, 2019 |
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Increasing Omega-3 reduces heart problems, autism, depression, preterm birth, breast cancer, etc. |
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15 Dec, 2017 |
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Preterm births strongly related to Vitamin D, Vitamin D Receptor, Iodine, Omega-3, etc |
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13 Nov, 2017 |
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Preterm birth extended by 2 weeks with Omega-3 – Meta-analysis Nov 2015 |
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10 Dec, 2016 |
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Omega-3 supplementation during pregnancy reduce early preterm births (save 1500 USD per child) – Aug 2016 |
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12 Oct, 2016 |
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Omega-3 helps pregnancy in many ways: preterm 26 percent less likely etc – review July 2012 |
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08 Sep, 2015 |
VitaminDWiki Vitamin D Receptor page with PRETERM of PRE-TERM in title (6 as of May 2022)
This list is automatically updated
Note: Less Vitamin D gets to cells when there is a poor Vitamin D Receptor
Items found: 6
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Preterm birth associated with many genes, including the Vitamin D Receptor again – Jan 2020 |
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30 Jan, 2020 |
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Preterm birth 8X more likely if poor Vitamin D Receptor – Dec 2019 |
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31 Dec, 2019 |
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Preterm birth 9 X more likely if fetus had a poor Vitamin D Receptor and previous miscarriage – Aug 2017 |
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12 Nov, 2019 |
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Preterm births 12 X more likely if poor Vitamin D Receptor (white infants in Italy) – meta-analysis Aug 2018 |
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27 Aug, 2018 |
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Preterm births strongly related to Vitamin D, Vitamin D Receptor, Iodine, Omega-3, etc |
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13 Nov, 2017 |
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Vitamin D Receptor is associated with preeclampsia, gestational diabetes and preterm birth – Nov 2017 |
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10 Nov, 2017 |