Risks of preterm births fall under new Australian initiative

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The rate of potentially fatal preterm births in Western Australian hospitals can be safely reduced by up to 20% when a coordinated series of interventions is applied to pregnant women, according to researchers at The University of Western Australia.

The detailed research findings, published in PLOS ONE, reveal a 7.6% reduction in preterm births across the State and a 20% reduction in WA's major perinatal centre King Edward Memorial Hospital, one year after introducing the WA Preterm Birth Prevention Initiative.

Head of UWA School of Obstetrics and Gynaecology Professor John Newnham AM said the initiative, which was launched in 2014, is underpinned by seven main interventions that aim to safely lower the rate of preterm births among pregnant women.

"The program's interventions included avoiding ending pregnancies before 39 weeks gestation, prescribing vaginal progesterone to women with a shortened cervix or a history of spontaneous preterm birth and strongly discouraging smoking whilst pregnant," Professor Newnham said.

"A new dedicated preterm birth prevention clinic was commenced at the tertiary centre while all interventions were promoted during 'The Whole Nine Months' social media campaign."

The benefit was strongest in women who would not usually be identified as high risk, indicating that the program should be applied to the entire population of pregnant women, not just those with risk factors.

The research team discovered the 20% reduction in preterm births at King Edward Memorial Hospital was sustainable, despite the number of high-risk cases at the hospital rising.

"The reduction in preterm births can be sustained in areas where the program is most intensive but remains at risk of dissipating elsewhere," Professor Newnham said.

A significant reduction in preterm births was noticed in the State's Kimberley region, where populations are spread across large distances and healthcare services are limited.

"The reduction could be attributed to the introduction of free progesterone treatment, which is usually very expensive, and the commencement of a midwifery continuity of care program which has been proven to prevent pregnancy complications."

The WA Preterm Birth Prevention Initiative was delivered in partnership with the Australian Preterm Birth Prevention Alliance, Woman & Infants Research Foundation, King Edward Memorial Hospital, The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Telethon and the Government of Western Australia Women and Newborn Health Service.

The Preterm Birth Prevention Initiative has been extended across Australia, with modifications introduced for each state and territory. Further information is available at the Australian Preterm Birth Prevention Alliance website.

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