[Efficient prevention of prematurity - the Thuringian model]

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Preventive Healthcare

Background:

• Prematurity and low birth weight pose significant risks to neonates.
• Vaginal milieu disturbances are linked to preterm birth.
• Early detection and intervention are crucial for improving pregnancy outcomes.

Purpose of the Study:

• To evaluate the effectiveness of a self-care program for prematurity prevention using vaginal pH self-measurement.
• To assess the impact of early screening and targeted therapy on reducing preterm birth rates.

Main Methods:

• Prospective study involving pregnant women performing twice-weekly vaginal pH self-measurements.
• Intervention group received education on self-measurement and immediate physician consultation for abnormal pH (> or = 4.7) or risk factors.
• Control group did not participate in the self-care program.
• Statewide pH screening program implemented in Thuringia.

Main Results:

• The intervention group showed a significant reduction in prematurity rate (8.1% vs. 12.3%) and very early preterm births (<32 weeks, 0.3% vs. 3.3%) compared to the control group.
• The statewide program in Thuringia demonstrated a significant decrease in early prematurity (1.58% to 0.99%) and low birth weight cases.
• Prematurity rates increased again after the program's discontinuation, indicating its effectiveness.

Conclusions:

• Self-care vaginal pH monitoring is an effective strategy for preventing prematurity.
• Early screening and targeted treatment (Lactobacillus acidophilus or clindamycin) significantly improve pregnancy outcomes.
• The program's success warrants expansion nationwide to reduce the burden of preterm birth.