A prospective randomized placebo-controlled trial reported in Pediatric Research evaluated antenatal N-acetylcysteine (NAC) supplementation for women facing imminent preterm birth. The study by Küster et al. described evidence supporting NAC as a potential strategy to reduce risk in at-risk pregnancies. For obstetric and perinatal care, NAC is positioned as an intervention that could fit into standard prenatal decision-making if results are confirmed in broader settings. The key outcome signals described center on prevention in pregnancies with imminent preterm delivery.