# Novel Tool Predicts Risk of Preterm Birth and Links it too Actionable Interventions
Researchers at NYU and partners within the International Healthy Outcomes of Pregnancy for Everyone (HOPE) Consortium have developed a novel tool, the Preterm Birth Actionable Risk Index (PTB-ARIx), designed to identify pregnant individuals at high risk for having a preterm birth (PTB, or delivery before 37 weeks).
By focusing on risk factors for PTB with known, evidence-based treatments – such as using low-dose aspirin to prevent preeclampsia, a life-threatening pregnancy complication marked by high blood pressure – the tool provides a potential pathway to link risk assessment directly to timely medical interventions.
“Our goal is to move from reacting to preterm birth to preventing it by providing families and healthcare professionals with knowledge that they can act upon,” said Laura Jelliffe-Pawlowski, professor and senior associate dean of research at NYU Rory Meyers College of Nursing who led the research.
The researchers present their findings on the PTB-ARIx at the annual meeting of the HOPE Consortium today, November 17, coinciding with World prematurity Day.
## The urgent need: rising rates and persistent gaps
Babies born prematurely are more likely to experience a range of health problems, and PTB is the leading cause of child mortality around the world. In the US, more than 350,000 babies are born prematurely each year, driving annual healthcare costs exceeding $25 billion.
Despite decades of research, the US PTB rate (for singleton births, not twins or othre multiples) rose from 8 percent to 8.7 percent between 2016 and 2023. This crisis is compounded by two major issues:
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Rising risk factors: The increase in PTB mirrors sharp upticks in maternal risk factors, including hypertension, diabetes, asthma, sexually transmitted infections, and mental health conditions. Such as, a recent NYU-led study found that the rates of preexisting diabetes, sexually transmitted infections, and mental health conditions more than doubled from 2011 to 2022, and national CDC data show that rates of gestational hypertension in black individuals rose more than 60 percent between 2016 and 2023, regardless of insurance status.
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The “know-do” gap: Many maternal risk factors can be effectively treated, which can help mitigate the risk of PTB – for instance, taking aspirin to prevent preeclampsia, using an inhaler for asthma, taking iron for anemia, or treating infections with antibiotics. However, these treatments are often underutilized, with some studies finding that only 57 percent of those at high risk for preeclampsia received low-dose aspirin and just 32 percent of those with asthma receiving inhalers or medications.
Moreover, treatment is unequal across racial and socioeconomic lines.