Actionable Risk Index aims to improve preterm birth prevention

The Preterm Birth Actionable Risk Index (PTB-ARIx) is a new tool designed to assess preterm birth risk using clinical factors that are not only predictive, but also actionable—meaning they have proven interventions associated with them.

According to Laura Jelliffe-Pawlowski, PhD, MS, professor at New York University, most prior prediction models have relied on broad, nonmodifiable indicators such as obesity, poverty, or race and ethnicity. While informative at a population level, these factors provide limited value for guiding individual care. The PTB-ARIx instead focuses on conditions that clinicians can address during pregnancy, including gestational and preexisting hypertension, diabetes, asthma, and mental health disorders.

Each of these conditions has established therapies—such as low-dose aspirin for hypertension, continuous glucose monitoring for diabetes, inhaler use for asthma, or medications and counseling for mental health needs. By combining these modifiable factors, the PTB-ARIx generates a prediction score that performed well in both the first and second trimesters, offering clinicians and patients an earlier and more actionable understanding of risk.

Jelliffe-Pawlowski noted that uptake of these therapies remains surprisingly low, with less than half of eligible pregnant individuals using recommended interventions. The PTB-ARIx aims to close this gap by helping patients recognize their risks, understand the treatments available, and increase adherence to them. The tool is intended to support richer patient-provider conversations by giving clinicians a comprehensive view of modifiable risk factors across conditions rather than addressing each one in isolation.

Effective communication, she emphasized, is central to improving outcomes. While clinicians often recommend interventions such as low-dose aspirin, they may not explain why they help—such as improving placental oxygenation and supporting fetal growth. Research shows that when pregnant individuals understand the rationale behind a therapy, they are more likely to use it consistently. The PTB-ARIx is intended to spark these deeper discussions, empowering patients with clearer information on how specific actions can reduce their risk.

This communication support is especially important for individuals with multiple risk factors—such as hypertension, diabetes, mental health conditions, homelessness, or intimate partner violence—who face elevated risk but still typically have only 15 to 20 minutes per prenatal visit. By helping organize and clarify risk information, the PTB-ARIx may serve as a practical bridge in time-limited clinical encounters, improving understanding, treatment uptake, and ultimately outcomes for those at highest risk of preterm birth.

No relevant disclosures.

Reference

NYU-led research team develops actionable tool to assess risk for premature births. New York University. November 17, 2025. Accessed December 5, 2025. https://www.eurekalert.org/news-releases/1106292