What Interventions Are Being Used to Prevent Preterm Birth and When?

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatal Health

Background:

• Preterm birth remains a leading cause of neonatal morbidity and mortality.
• Preventive interventions like progesterone, cerclage, and pessary are available for women at risk.
• Disparities in access and utilization of these interventions may exist across different healthcare settings.

Purpose of the Study:

• To determine the proportion of high-risk women who received progesterone, cerclage, or pessary for preterm birth prevention.
• To assess if the utilization of these interventions varied between primary, secondary, and tertiary care centers.

Main Methods:

• Retrospective cohort study analyzing medical records of women with estimated dates of confinement.
• Inclusion criteria: previous spontaneous preterm birth or short cervix.
• Data extraction on offered and received preventive interventions; statistical analysis including Fisher exact tests.

Main Results:

• Out of 1024 reviewed charts, 31 women met the criteria for high-risk preterm birth.
• Only 42% of these women received progesterone or cerclage; no women received a pessary.
• 26% were not referred to specialists in time, and 57% of those referred before 24 weeks received an intervention.

Conclusions:

• A significant proportion of women at risk for preterm birth do not receive recommended preventive interventions.
• There is a critical need to enhance knowledge translation strategies to improve timely referral and uptake of progesterone therapy.
• Optimizing the use of available preventive measures is essential for reducing preterm birth rates.