Preterm birth is a global health problem that affects 11% of all live births: it remains a significant cause of death and an important cause of long-term loss of human potential among survivors all around the world. In the last decade, many developed countries have seen an increase in the rate of infants born preterm. Various theoretical and practical concepts have been discussed that aim to optimize the perinatal care of preterm infants and their mothers. These include the definition of hospitals with different levels of care, the regionalization of care, the creation of large care units with high case numbers, and a high level of expertise. This review article focuses on the connection between health care structures and different aspects of preterm birth. Furthermore, this review article highlights the fact that preterm birth is a heterogeneous syndrome with many underlying pathologies and that the causality for a large number of cases remains unexplained. There is still a significant knowledge gap concerning the actual drivers of spontaneous preterm birth, and future research particularly in parturition immunology as well as genetics of prematurity will be essential to identify new targets for therapy.

早产是一个全球性的健康问题，影响着所有活产中的11％：它仍然是重要的死亡原因，也是全世界幸存者长期丧失人类潜能的重要原因。在过去的十年中，许多发达国家的早产婴儿比率有所增加。讨论了各种理论和实践概念，旨在优化早产儿及其母亲的围产期护理。这些包括定义具有不同护理级别的医院，护理区域化，创建具有高病例数的大型护理单位以及高水平的专业知识。这篇评论文章重点关注医疗保健结构与早产不同方面之间的联系。此外，这篇评论文章强调了这样一个事实，即早产是一种具有多种潜在病状的异质综合症，并且对于许多病例的因果关系仍无法解释。关于自发性早产的实际驱动因素仍然存在巨大的知识空白，未来的研究，特别是分娩免疫学以及早产遗传学，对于确定新的治疗靶点至关重要。