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Can preterm deliveries be prevented?

D M Main, S G Gabbe, D Richardson

    American Journal of Obstetrics and Gynecology
    |April 1, 1985
    PubMed
    Summary
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    This study found that an antepartum program did not significantly reduce preterm birth rates in high-risk inner-city women. Further research is needed to improve interventions for preventing preterm labor.

    Area of Science:

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

    Background:

    • Inner-city women face a high preterm delivery rate (17%).
    • Antepartum programs with education and follow-up have shown success in other populations.
    • Effective interventions for preterm labor prevention in underserved communities are needed.

    Purpose of the Study:

    • To investigate the impact of an antepartum program on preterm delivery rates in high-risk, inner-city women.
    • To evaluate patient education and close follow-up as interventions for preterm labor prevention.
    • To compare outcomes between an intervention group and a high-risk control group.

    Main Methods:

    • A controlled, randomized study design was employed.
    • High-risk patients (identified by Creasy system before 18 weeks' gestation) were randomly assigned.

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  • Intervention included the Preterm Labor Prevention Clinic; controls received standard care.

    • Main Results:

    • No significant differences were observed in preterm infant percentages, mean gestational age, or birth weight between groups.
    • Preterm rupture of membranes was a significant factor (40%) in preterm deliveries.
    • Indicated preterm births (maternal/fetal reasons) and tocolytic therapy failure each accounted for 30% of preterm births.

    Conclusions:

    • The studied antepartum program did not significantly reduce preterm delivery rates in this high-risk, inner-city population.
    • Preterm rupture of membranes and indicated preterm births remain significant challenges.
    • Further investigation into effective preterm labor prevention strategies for diverse populations is warranted.