[Prevention of prematurity by psychotherapeutic management]

The establishment of the mother-baby relationship is often disturbed in case of preterm birth. Clinical observations and epidemiological studies have highlighted the existence of a relationship between psychological factors and preterm birth. Therefore, a psychological support may have a beneficial effect in order to prevent preterm delivery. The aim of this study was to assess the effectiveness of psychological support in pregnant women with symptoms of preterm labor, which is considered as a somatic expression of psychological difficulty related to pregnancy. The study, which involved two cohorts of women, hospitalized or not, identified during two successive periods in the same maternity ward, included 309 women in the experimental group and 323 in the control group. The women in the control group were followed up according to the usual therapeutic procedures, whereas additional psychological support was offered to the experimental group. 92% of the women who met the psychologist accepted the psychological support. The analysis, conducted "in intent to treat", showed a significant decrease in the preterm birth rate in the experimental group (12%) compared with the control group (26%). This study confirms the feasibility of this kind of intervention and the effectiveness of psychological support on the risk of preterm delivery. The interviews help the women regain confidence in their own capacity to fulfil their pregnancy.