Journal
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
Volume 34, Issue 23, Pages 3833-3837Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14767058.2019.1698029
Keywords
Preterm birth; preterm protocols; prevention; cerclage; progesterone
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The study found that the implementation of five protocols aimed at reducing preterm birth rates at TJUH led to a significant decrease in preterm birth rates from 2004 to 2014, especially among women delivering at 28-33 weeks. The decline in preterm birth rates at TJUH was greater than the national average in the USA, possibly due to the early adoption of guidelines for the prevention of preterm birth.
Objective: To evaluate if the implementation of five protocols aimed at reducing the preterm birth rate were associated with a decrease in incidence of PTBs at an academic center. Methods: This is an observational study of women with singleton gestations delivered at TJUH between 2004 and 2014. Primary outcome was the annual incidence of PTB <37 weeks at TJUH. Secondary outcome was the rate of change for PTBs at TJUH compared against that of the nation. Linear regression, Pearson correlation coefficients, and t-tests were used to analyze preterm birth rates over time. Results: TJUH incidence of PTB < 37 weeks significantly decreased from 10.8% (n = 206) in 2004 to 9.1% (n = 169) in 2014 (p = .001). Linear regression showed a dramatically greater rate of decline at TJUH (0.32% per year, p = .001) compared to that of the USA (0.14% per year, p < .0001). Early PTBs (28-33 6/7 week) at TJUH had the steepest rate of decline at 0.13% per year (p = .001). Late PTBs (34-36 6/7 week) at TJUH were the only group to not have a significant rate of decline (p = .114). Conclusion: The incidence of PTBs at TJUH decreased more than the USA national average in the study period, which may be due to early adoption of guidelines for prevention of PTB. Condensation: The incidence of PTBs at TJUH decreased more than the USA national average in the study period, which may be due to early adoption of guidelines for prevention of PTB.
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