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Reducing preterm birth by a statewide multifaceted program: an implementation study
John P Newnham1, Scott W White1, Suzanne Meharry2
1Maternal-Fetal Medicine Service, King Edward Memorial Hospital, Perth, Western Australia, Australia; School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, Australia.
Insights
A comprehensive preterm birth prevention program in Western Australia successfully reduced singleton preterm births by 7.6%. This initiative, targeting healthcare providers and the public, demonstrated significant effectiveness in lowering early birth rates.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Perinatal Medicine
Background:
- A multifaceted preterm birth prevention program was implemented in Western Australia.
- The program included new clinical guidelines, healthcare practitioner outreach, public health campaigns, and a specialized high-risk pregnancy clinic.
- The initiative aimed to reduce the state's preterm birth rate.
Purpose of the Study:
- To evaluate the impact of the comprehensive preterm birth prevention program on statewide and tertiary center preterm birth rates.
- To assess the effectiveness of the integrated approach to preterm birth reduction.
Main Methods:
- Prospective population-based cohort study design.
- Comparison of perinatal outcomes before and after one year of program implementation.
- Analysis of statewide and tertiary perinatal referral center data.
Main Results:
- Statewide singleton preterm birth rate decreased by 7.6% after program implementation.
- The reduction represented 196 fewer cases compared to the previous year, with effects seen from 28-31 weeks gestation.
- The tertiary level perinatal center also observed a significant decrease in preterm birth rates in 2015.
Conclusions:
- A comprehensive, multifaceted preterm birth prevention program within a universal healthcare system can significantly reduce early birth rates.
- The program's success highlights the potential of combined strategies targeting healthcare professionals and the public.
- Further research is needed to optimize interventions and determine the specific contribution of each program component.
Background:
A comprehensive preterm birth prevention program was introduced in the state of Western Australia encompassing new clinical guidelines, an outreach program for health care practitioners, a public health program for women and their families based on print and social media, and a new clinic at the state's sole tertiary level perinatal center for referral of those pregnant women at highest risk. The initiative had the single aim of safely lowering the rate of preterm birth.
Objective:
The objective of the study was to evaluate the outcomes of the initiative on the rates of preterm birth both statewide and in the single tertiary level perinatal referral center.
Study Design:
This was a prospective population-based cohort study of perinatal outcomes before and after 1 full year of implementation of the preterm birth prevention program.
Results:
In the state overall, the rate of singleton preterm birth was reduced by 7.6% and was lower than in any of the preceding 6 years. This reduction amounted to 196 cases relative to the year before the introduction of the initiative and the effect extended from the 28-31 week gestational age group onward. Within the tertiary level center, the rate of preterm birth in 2015 was also significantly lower than in the preceding years.
Conclusion:
A comprehensive and multifaceted preterm birth prevention program aimed at both health care practitioners and the general public, operating within the environment of a government-funded universal health care system can significantly lower the rate of early birth. Further research is now required to increase the effect and to determine the relative contributions of each of the interventions.
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