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Premature birth (PR) remains the leading cause of perinatal morbidity and mortality in multiple pregnancies, the frequency of which is steadily increasing due to the development of assisted reproductive technologies. The purpose of this article is a systematic analysis of current data on risk factors and predictors of PR in women carrying multiple pregnancies. Based on the analysis of literature sources, key unmodifiable (type of zygosity, parity, maternal age, obstetric history) and modifiable (smoking, infections, short intergenetic interval, BMI) risk factors are identified. Special attention is paid to the prognostic significance of the length of the cervix during transvaginal ultrasound, the determination of fetal fibronectin, as well as the role of anamnestic data and the course of a real pregnancy. Understanding and timely identification of these factors and predictors is crucial for risk stratification, optimization of prenatal follow-up, timely prevention (prescribing progesterone, cerclage), and selection of optimal management tactics aimed at prolonging pregnancy and improving perinatal outcomes.
Keywords:multiple pregnancies, premature birth, risk factors, predictors, cervicometry, fetal fibronectin, progesterone, perinatal outcomes
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