Preterm birth remains the leading cause of child mortality worldwide, and US rates are creeping upward despite decades of research.

More than 350,000 babies are born prematurely in the United States each year, with rising maternal risk factors such as hypertension, diabetes, asthma, infections, and mental health conditions driving much of the increase.

Many of these risks are treatable, yet evidence-based interventions—like low-dose aspirin for preeclampsia or inhalers for asthma—are often underused; for example, only 57% of those at high risk for preeclampsia receive aspirin, and just 32% of pregnant patients with asthma get appropriate medications.

To close this “know-do” gap, researchers within the International Healthy Outcomes of Pregnancy for Everyone (HOPE) Consortium developed the Preterm Birth Actionable Risk Index (PTB-ARIx), a tool that links risk identification directly to treatments that can help.

Using data from 1.9 million singleton births in California, the index scores 18 first- and second-trimester factors—including clinical issues (preeclampsia risk, diabetes, anemia, infections), behaviors (smoking, substance use), and social stressors (food insecurity, housing instability)—on a scale from 0 to 3+.

High scores strongly predicted serious outcomes: more than 70% of pregnancies with scores ≥3 resulted in preterm birth or another major complication, and each one-point increase in score raised PTB risk by over 60%.

Preeclampsia-related risk emerged as the single strongest predictor, with affected individuals 6.7 times more likely to experience preterm birth, underscoring the importance of blood pressure monitoring and preventive care.

Encouragingly, the PTB-ARIx performed consistently across racial and ethnic groups and insurance types, and regular prenatal visits appeared to reduce risk, even among those with higher scores.

The team is now working to pair the index with treatment data, develop an early-pregnancy immune-signal blood test, and ultimately build a digital platform that helps clinicians and families act earlier to prevent avoidable preterm births.

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Adapted from: “Researchers Develop Novel Tool to Identify Pregnant Women at High Risk for Having a Preterm Birth.” News-Medical, November 17, 2025. Available at: https://www. news-medical.net/news/20251117/ Researchers-develop-novel-tool-toidentify-pregnant-women-at-high-riskfor-having-a-preterm-birth.aspx