Preventing early births in a regional tertiary maternity unit -
evaluating preterm and early term birth rates before and after
implementation of the Preterm Birth Prevention Initiative in the
Australian Capital Territory: a pre and post interventional study
Abstract
Objective To evaluate the Australian Capital Territory (ACT) Preterm
Birth (PTB) Prevention Initiative and its effects on preterm and early
term birth rates at the main tertiary hospital after 16 months of
implementation. Design: A non-randomised before and after study, where
the intervention was a multifaceted PTB prevention initiative. Setting:
The main tertiary referral hospital in the ACT. Population: Women who
birthed at the main tertiary hospital in the ACT in the pre and post
intervention period. Methods: The PTB prevention initiative was
implemented in 2019. Rates of early birth were assessed using run charts
of bimonthly preterm and early term rates from 2014-2020. Main Outcomes
measured: The main outcomes measured were rates of preterm and early
term births before and after implementation of the PTB prevention
initiative. Results: At the main tertiary hospital in the ACT, the rate
of PTB was significantly reduced by 10% after 16 months of
implementation of the initiative, corresponding to 45 averted or delayed
PTBs. The number of iatrogenic early term births with no medical
indication (NMI) was significantly reduced by 34.5% and resulted in 77
averted or delayed early term births. Conclusions: The multifaceted PTB
prevention initiative safely lowered the rates of early birth in the ACT
context. These results highlight the importance of prioritising early
birth prevention, education, research and expanding the PTB Prevention
Initiative nationwide.