Preventing Low Birthweight (1985) / Chapter Skim
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C. A Summary of Three Prematurity Prevention Programs
C. A Summary of Three Prematurity Prevention Programs
Pages 266-274
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From page 266... ...
Basic type of program: The original San ~rancisco program was a longitudinal demonstration project to test the effectiveness of an educational program for patients at risk of preterm labor and for providers of obstetric care. This program focused on self-detection of early signs of preterm labor to allow patients to be treated as soon as possible with tocolys~s.t The program also .
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From page 267... ...
2. Health care providers: The program utilizes both physicians and nurse practitioners to carry out risk assessment, to allocate into study/control groups, to provide primary care, and to supervise the overall program.
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From page 268... ...
Basic type of program: This is a randomized tr ial to test the effectiveness of five different interventions designed to prevent preterm labor, superimposed on an intensive educational program for both patients and providers. Health care providers: The program uses nurse practitioner teams to carry out risk assessment; allocation of intervention; primary care; and supervision of the program components, including education, social service, nutrition, home visits, and the audit of outcome.
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From page 269... ...
a. The education program for the provider concentrates on the concept of the prevention program, the importance of program design, methods of risk assessment, justification for the interventions, description of the patients' education program, reasons for hospitalization for early preterm labor, importance of continuity of care, and benefits of a successful program.
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From page 270... ...
Basic type of program: The French program is a national longitudinal one begun in 1971. It includes certain clinical components, described below, and ~ s supported by complete work leave beginning at 34 weeks, monetary payments for early prenatal care, and free obstetric care.
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From page 271... ...
Some practitioners use a risk assessment "score card, n while others no longer formally score patients because the notion and content of risk assessment have become a standard part of patient care. The most important parts of the Papiernik risk assessment system are the assessment of lifestyle and physical work, the patients' recognition of uterine contractions, and pelvic examinations to uncover those signs strongly indicative of the risk of preterm labor.
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From page 272... ...
In the tables that follow, declining rates of preterm births are presented for a Smart teaching hospital, the region of Haguenau, for France generally, and for the Mar tinique program. In the absence of a careful statistical approach to implementing the preterm prevention strategies outlined here, it is not possible to determine the cause of the declines noted.
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From page 273... ...
TABLE C.3 Preterm Births.per 100 Live Births by Week of Gestation in Haguenau, France, 1971-1982 Week of Gestation 1971-74 1975-78 1979-82 <32 1.8 1.3 0.8 33-34 1.2 1.0 0.8 35-36 3.1 2.4 2.5 <37 6.l 4.5 4.2 Now;: - Preterm births are live births of less than 37 weeks gestation. TABLE C.4 Preterm Births per 100 Live Births by Week of Gestation, France, National Representative Studies Week of Gestation 1972 1976 1981 <34 2.4 1.7 1.2 34-36 5.8 5.1 4.4 <37 ~ ;-8.2 6.8 5.6 NOTE;: Preterm births are live births of less.
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From page 274... ...
274 TABLE C.5 Live Births and Percent Preterm Among Women Followed in the Martinique Prenatal Care System 1980 1981 1982 Births 2250 2326 2526 Percent preterm 6.0 5.0 4.4 Per inatal mortality ratea 16 13 12 NOTE: Preterm births are live births of less than 37 weeks gestation aFor infants weighing 500 grams or more e e
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