• Education and provider engagement emerged as a unifying prevention strategy across rural and urban settings, combining patient education, provider training, and proactive risk communication to reduce preterm birth rates. This pattern recurs in several programs, linking knowledge dissemination to improved outcomes [9], [10], [3], [2], [6], [7], [5].

• Risk stratification and targeted interventions guided resource allocation, concentrating prevention efforts on high‑risk pregnancies and distinct etiologies. Programs implement risk scoring, selective follow‑up, and education in Alabama, indigent populations, and urban centers [6], [10], [11], [2].

• Ambulatory and home‑based surveillance strategies tested whether monitoring uterine activity or delivering care at home could prevent birth, aiming for safe, less invasive prevention and reduced hospital burden. Trials emphasize regular monitoring, cervical assessments, and timely provider contact [4], [9], [18].

• Infection‑related prevention approaches emphasize infection control, from adjunctive antibiotics in idiopathic preterm labor to GBS chemoprophylaxis, highlighting infection as a modifiable etiologic lever [12], [19], [20].

• System‑level interventions and prenatal care access show how health policy and program design affect preterm birth outcomes, with demonstrations in Medicaid, rural and urban programs and cost‑effectiveness analyses [2], [14], [15], [10].