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Schumacher, I. and Piso, B. (2012): Reorientation of the Austrian parent-child preventive care programme. Part V: Measures to reduce preterm birth. HTA-Projektbericht 50.

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Abstract

Background: During the first year of our project on the ´reorientation of the Austrian parent-child preventive care programme´, we identified preterm birth as highly relevant health topic. The aim of part V of this project was to identify suitable primary and secondary preventive measures as well as screening methods to reduce the number of preterm births.

Methods: Based on a systematic literature search in Medline, Embase, the Cochrane Library and CRD we included systematic reviews and metaanalyses published between 01/2000 and 4/2011 for qualitative analysis.

Results: We identified twelve reviews on primary prevention, five on screening and 39 on secondary prevention of preterm birth. For a few of the measures analysed we were unable to find any relevant information, for almost half of the measures we found no between-group differences in preterm birth outcomes. Nevertheless we identified some single interventions especially for well-defined subgroups of pregnant women, which tend to show a positive effect on preterm birth, e.g. zinc- or calcium supplementation or energy- and protein intake for undernourished women, long-chain polyunsaturated fatty acids for pregnant women at risk (e.g. because of previous preterm birth), the screening for vaginal infections or elevated fetal fibronectin, antiplatelet agents for preeclampsia prophylaxis for women with gestational hypertension, cerclage for women with short cervix and previous preterm birth, bed-rest for women with hypertension, as well as nutritional advice for pregnant women or telephone support for women at risk of preterm birth.

Conclusion: Before implementing these “promising” measures and those which showed a more distinctive positive effect (smoking cessation programmes and prophylactic progesterone for women with a previous preterm birth) into a parent-child preventive care program, it will be necessary to take the strengths of association between risk or protective factors with preterm birth, and the prevalence of these factors in the population into account. Finally, potential “structural” causes of the (compared to other European countries) high Austrian preterm birth rate should be considered (e.g. heterogeneous definitions, influences of assisted reproductive technologies or caesarean sections).

Item Type:Project Report
Keywords:preterm birth, screening, prevention
Subjects:WA Public health > WA 108-245 Preventive medicine
WA Public health > WA 525-590 Health administration and organisation
WA Public health > WA 310 Maternal and child welfare
WQ Obstetrics > WQ 200-212 Pregnancy
Language:German
Series Name:HTA-Projektbericht 50
Deposited on:18 Jan 2012 13:44
Last Modified:08 Sep 2014 12:37

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